Program Therapist (LMFT/AMFT / LCSW/ACSW / LPCC/APCC)
Job Description
Job Description
Position Summary
The Program Therapist provides clinical services to clients in individual, family, and group settings. The therapist conducts biopsychosocial assessments, develops and implements treatment plans, provides psychoeducation, facilitates relapse prevention, and ensures compliance with state and federal documentation requirements.
The therapist ensures compliance with state, federal, and payer-specific documentation and billing standards for both public (DMC-ODS) and private/commercial insurance clients.
This role functions as a Licensed Practitioner of the Healing Arts (LPHA) under DMC-ODS and DHCS guidelines and includes supervision of AMFTs/trainees as appropriate. The Program Therapist collaborates with the Clinical Director, SUD Counselors, Medical Providers, and Program Director to ensure integrated care and adherence to all regulatory standards.
Essential Duties and Responsibilities
- Conduct comprehensive intake assessments, biopsychosocial evaluations, treatment plans, and discharge summaries in accordance with DHCS, DMC ODS, and Joint Commission standards.
- Facilitate individual, group, family, and couples therapy using empirically supported modalities (CBT, DBT, Motivational Interviewing, trauma-informed approaches).
- Demonstrate working knowledge of private and commercial insurance requirements (e.g., Molina, Optum, Kaiser, Blue Shield Promise, TriWest, MHN, Aetna) including medical necessity criteria, authorization limits, concurrent reviews, and step-down justification.
- Collaborate with the billing and utilization management (UM) teams to ensure documentation supports medical necessity and meets payer standards for authorization and continued stay.
- Maintain clinical documentation within required timeframes using electronic medical records (EHR), ensuring accuracy for billing and audit readiness.
- Provide care coordination and collaborate with medical providers, case managers, and community agencies to ensure continuity of care and alignment with payer requirements.
- Provide care coordination and collaborate with medical providers, case managers, and community agencies to ensure continuity of care.
- Maintain clinical documentation within required timeframes using electronic medical records (EHR).
- Monitor and document client progress toward treatment goals; participate in case consultation and interdisciplinary treatment team meetings.
- Provide clinical supervision to AMFTs and MFT trainees consistent with BBS regulations and agency policies.
- Develop and implement crisis intervention and safety planning; respond to emergent client needs.
- Coordinate and ensure compliance with medical screenings and annual physical, TB, and mental health assessments as required.
- Participate in developing and improving clinical programming and policies to align with DHCS and Joint Commission standards as well as commercial insurance utilization requirements.
- Support the Program Director in mental health portions of policy and procedure (P&P) development.
- Provide psychoeducation and relapse prevention education to clients and families.
- Maintain professional communication with staff, clients, and families, demonstrating cultural humility and sensitivity to diverse populations.
- Attend required trainings, supervision, and continuing education to maintain clinical competencies.
- Perform administrative tasks such as forms, reports, evaluations, and case documentation.
- Other duties as assigned by the Program Director or Clinical Director.
Core Competencies
- Strong understanding of co-occurring disorders, relapse prevention, and evidence-based treatment modalities.
- Knowledge of DHCS, DMC ODS, and commercial payer documentation/billing compliance standards.
- Ability to interpret and apply ASAM placement criteria and medical necessity language for both Medi-Cal and private insurance authorizations.
- Competence in recognizing early indicators of mental health or physical deterioration and initiating appropriate interventions.
- Ability to engage clients with empathy, maintain professional boundaries, and model recovery-oriented behavior.
- Skilled in conflict resolution, de-escalation, and trauma-informed communication.
- Proficient in EHR documentation, report writing, and communication with billing and utilization review staff to ensure authorization compliance.
Minimum Qualifications
- Master’s Degree in Counseling, Social Work, Psychology, or related behavioral health field.
- Active, unrestricted California license as LMFT/AMFT, LCSW/ACSW, LPCC/APCC, or Clinical Psychologist/Associate.
- Minimum of 1 year full-time post-master’s experience providing direct client services in a mental health or co-occurring disorder program.
- Qualified Supervisor for AMFTs/MFT Trainees per BBS standards.
- Valid and current CPR/First Aid, TB clearance, Driver’s License, DOJ/Federal background clearance, and Employment Physical Exam.
- Minimum 6 months experience treating co-occurring and SUD populations.
Preferred Qualifications
- Knowledge of private/commercial insurance workflows, including concurrent review, discharge planning, and authorization extension.
- Familiarity with EDI claims requirements, CPT/HCPCS codes and payer-specific documentation guidelines.
- Experience with DMC-ODS, ASAM criteria, and Joint Commission standards.
- Experience with electronic medical record systems (e.g., KIPU).
- Training or certification in trauma-informed care, DBT, CBT, or relapse prevention.
- Bilingual (Spanish/English) preferred.
Physical Requirements
- While performing the duties of this job, the employee is regularly required to sit, stand, walk, bend, and reach. Must be able to lift up to 25 lbs occasionally and assist during client emergencies. Reasonable accommodations will be made for qualified individuals with disabilities.
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