Job Title: Utilization Management (UM) Manager (RN, LPC, LCSW or LMFT)

Position's Role Summary:

Do you want to make a difference? Do you have a passion for helping others and want a career where you can make a difference? Then join our NTBHA team where we have proved to be a strong, self-sufficient and enduring foundation within our community. We are committed to connecting and serving our clients where they live.

North Texas Behavioral Health Authority (NTBHA), based in Dallas is responsible for developing a collaborative system of care for children, adolescents and adults with severe mental illness and other serious emotional disturbances, as well as those experiencing a substance use disorder. This position's actions and work must align with NTBHA's values and goals, policies and procedures, and meet all documentation standards and regulatory requirements.

Job duties, responsibilities, and skills:

• The UM Specialist's primary functions are granting authorizations and conducting utilization reviews for behavioral health services per clinical information given by providers and internal criteria for medical necessity and appropriateness of care.
  • Specialists will monitor compliance with and for various contracts entered into by NTBHA, including with the State of Texas.
  • Data entry, maintaining files and reports, and performing other routine office work are required in this position.
  • This position will require excellent communication, organizational and documentation skills as well as the ability to use multiple computer software applications, including WebCARE and CMBHS.
  • Utilization management and utilization review work is achieved under general supervision with considerable latitude for the use of initiative and independent judgment.
• Must be able to work on and have knowledge of a PC (personal computer).
• Advanced Microsoft Office Suite skills - Outlook, Word, Excel, PowerPoint, etc. with an ability to become familiar with company-specific programs and software.
• Duties and projects may be assigned or changed to meet business needs.

Qualifications required:

• Licensed Practitioner of the Healing Arts (LPHA) in the state of Texas, RN, LPC, LCSW or LMFT.
• At least five years' experience in direct care of persons with a serious mental illness, documented training in psychopharmacologic management of serious mental illness, and medical/psychiatric co-morbidity and complications in chronic serious mental illness.
• At least five years' experience participating as a member of a treatment team that develops and monitors treatment plans for persons with chronic & serious mental illness.
• At least one-year experience with the implementation of utilization management policies, procedures, and protocols for MH services, either as a provider or manager; at least one-year experience supervising MH providers.
• Work autonomously and to make decisions consistent with applicable rules, regulations, policies and procedures.
• Create, analyze, prepare, and maintain records, files, documents, reports, and correspondence.
• Recognize problems and identify and facilitate solutions. Knowledge of community resources, local indigent behavioral health systems and local authority/service coordination principles, objectives, standards and methods, and of program policies and procedures.
• Communicate effectively and use effective interpersonal skills to communicate ideas and complex concepts with individuals from diverse cultural and socio-economic backgrounds through oral and written communication.
• Constructively and efficiently work with other professionals and staff, community representatives, persons with disabilities, and family members.
• Foster strong, positive, and effective working relationships with inter-agency and intra-agency team members, encouraging and supporting interaction among various team members across organizational lines.

We are responsible for developing a collaborative system of care for individuals in crisis in the NTBHA service area. We are focused on trauma-informed, resilience-oriented care in all services provided.

Job Type: Full-time exempt

Benefits:

401(k)

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance