Program Administrator- UM/QM

GENERAL DESCRIPTION

The Program Administrator of BH UM/QM is responsible for the administration of all quality, regulatory, and compliance activities for the Behavioral Health Division to ensure that services are provided in accordance with all regulatory and accreditation requirements.  This position serves as primary lead for oversight for Quality Management function, Utilization Management functions, and Clinical Quality measures ensuring satisfactory results on audits and effective management of clinical and fiscal resources and promotion of service excellence in a person driven, trauma informed, and culturally and linguistically appropriate manner.

 This position will work closely with the Director of Behavioral Health Quality Assurance and Support and Behavioral Health Operations Team to manage and develop the Consolidated Local Service Plan (CLSP) and Local Provider Network Development Plan (LPNDP). The Program Administrator of BH UM/QM will provide support to the Planning and Network Advisory Committee (PNAC) and coordination of the service systems with HHSC and the community, as needed. The Program Administrator of BH UM/QM is responsible for timely submissions of reports and dashboards. This position will facilitate the UM/QM meetings and team meetings. This position is responsible for regular fidelity audits, summarizing findings, recommending quality improvements, and collaborating with training department on training needs identified in audits. Additionally, this position is responsible for maintaining the TA calendar for contract networks to review performance standards, contract requirements, and utilization as well as maintaining the audit calendar for all contractors at intervals necessary to monitor performance and corrections.

 This position requires management of budgets, supervision of staff at various professional levels, and will provide backup/support for UM team. This position requires innovation and investigation in quality and utilization oversight. This position will work collaboratively with the Director of Behavioral Health Quality Assurance and Support on responding to and resolving questions and complaints from individuals/families, contractors, and stakeholders.

 The Program Administrator of BH UM/QM serves as the UM Director and does not provide, nor supervise anyone who provides directs services. This position supervises the UM/QM team and medical records.

EDUCATION, TRAINING, & EXPERIENCE

• Master’s Degree in Psychology, Counseling, Social Work, or Related Field required.
• Fully licensed as LPC, LCSW, or LMFT required. Supervisor status highly preferred.
• 5 years’ experience in the treatment of individuals with mental illness or chemical dependence required.
• 3 years’ experience in a supervisory role required.
• 3 years’ experience in the role of utilization and/or quality management required.
• Experience in the management of budgets, design of processes and systems for delivering community-based services, and coordination with a large management structure and stakeholder groups highly preferred.
• Experience working in a Certified Community Behavioral Health Clinic (CCBHC) highly preferred.

ESSENTIAL TASKS & STANDARDS

Core Value: Continuous Improvement in Measurable Ways

 Responsible for administration of all Quality Management activities to ensure compliance with all regulatory and contractual quality management requirements for behavioral health services including internal and external programs.

Core Value: Continuous Improvement in Measurable Ways

 Responsible under the direction of the Behavioral Health Operations Team to prepare for and support any internal or external audits/reviews for or by LPS, or by HHSC or other governing authority.

Core Value: Stewardship of Resources

 Responsible for administration of Utilization Management function within BH.

Core Value: Integrity

 Responsible for identifying any regulatory changes and that all BH workforce members are trained appropriately for their position.

Core Value: Service Excellence

 Responsible for capturing and reporting targets and quality measures; identifying areas of concern and working collaboratively to develop solutions.

Core Value: Community

 BH Services Management Team

 Works actively as a part of the BH Services Management Team to ensure the division’s success and the achievement of the Center’s overall goals.

Core Value: Continuous Improvement in Measurable Ways

Serves as the UM Director

KNOWLEDGE, SKILLS, & ABILITIES

• Comprehensive knowledge of Texas Administrative Codes that relates to Mental Health Community Centers, Info Item V Standards, and UM guidelines.
• Full understanding of continuum of care options, least restrictive environment, and medical necessity.
• Comprehensive knowledge of mental health diagnoses, recovery-oriented practices, crisis procedures psychotropic medications, and clinical processes.
• Skilled at working with a variety of staff to develop efficient and effective systems for providing quality services and the appropriate training to implement and monitor these processes.
• Able to communicate effectively verbally and in writing; understand and synthesize a wide range of information; use computer technology effectively for management information purposes; develop reports and other forms of communication for a variety of audiences and purposes.
• Able to delegate tasks appropriately amongst team members for operational excellence.
• Able to deal with individuals and families in a compassionate and professional manner to resolve complaints.
• Ability to work effectively within a complex management structure.
• Able to exercise constant flexibility and adaptability to accommodate the complex nature of community behavioral health services.
• Demonstrated ability to ensure effective communication regarding QM and UM operations, performance, and
• Works under general supervision with moderate latitude for the use of initiative and independent judgment.
• Knowledge of the social services system and the ability to guide staff in connecting individuals with appropriate services.
• Organized, detail oriented, computer proficient, and able to write clearly and professionally.
• Ability to respond to individuals with patience, empathy, and understanding.

CERTIFICATES, LICENSES, & REGISTRATIONS

• Must have valid Texas Driver License and a good driving record.
• Must be able to pass a criminal background check.
• Must be able to complete all LifePath Systems training.
• Must be able to provide at least 3 professional or educational references. 

BENEFITS

Salary Range: $85,000 - $95,000 per year            

Shift Hours: Monday - Friday  8am - 5pm (Position is remote after all training is completed. May require some early mornings, later evenings, and occassional weekend.)

We offer a competitive salary and comprehensive benefit package including medical, dental, FSA, 401(k), voluntary benefits, Paid Time Off (PTO) and Extended Illness (EI), and Holidays.

If interested please complete an online application at LifePath Systems Job Openings and attach your resume

Equal Opportunity Employer

LifePath Systems is an equal opportunity employer (Minorities/Females/Disabled/Veterans). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.

To read more about this, view the EEO is the Law poster and this EEO is the Law Poster Supplement.