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Therapy Analyst

Date:  Sep 15, 2025
Location: 

AUSTIN, TX

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

 

Functional Title: Therapy Analyst 
Job Title: Registered Therapist V 
Agency: Health & Human Services Comm 
Department: UR Acute Care FTE 75 
Posting Number: 9092 
Closing Date: 10/15/2025 
Posting Audience: Internal and External 
Occupational Category: Healthcare Support 
Salary Group: TEXAS-B-27 
Salary Range: $7,015.16 - $11,864.50 
Pay Frequency: Monthly
Shift: Day 
Additional Shift:  
Telework:  
Travel: Up to 10% 
Regular/Temporary: Regular 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Exempt 
Facility Location:  
Job Location City: AUSTIN 
Job Location Address: 701 W 51ST ST 
Other Locations:  
MOS Codes: 230X,42BX,42NX,42TX,65A,65B,68F,68L,HM,HN,HS,SEI12 
 
 
 




Brief Job Description:

The Registered Therapist V, Managed Care Therapy Analyst, is a senior level position that reports to an Acute Care Utilization Review (ACUR) Unit’s Managed Care Clinical Review Manager. This employee will ensure Texas Medicaid recipients have appropriate access and coordination of medically necessary services through contracted managed care organizations (MCOs) in the STAR, STAR+PLUS, STAR Kids, and STAR Health programs. This position will establish a process to oversee Medicaid managed care organizations (MCOs) efficacy of prior authorization (PA) and utilization review (UR) processes to reduce unnecessary and inappropriate occupational, physical and speech therapy services, Applied Behavioral Analysis services, and Durable Medical Equipment. This position will also safeguard against access to care disparities by ensuring Medicaid MCOs are not underutilizing acute care services by denying necessary and appropriate services. This position will serve as a subject matter expert to other departments within Health and Human Services Commission regarding therapy services.

 

Essential Job Functions:

All essential job functions must ensure compliance and knowledge of Texas Medicaid MCOs utilization management with HHSC contracts, state and federal regulations related to STAR Kids, STAR, STAR+PLUS, and STAR Health programs:

  • Reviews and analyzes, Medicaid MCO policies and procedures, utilization review and clinical documentation. All the tasks listed below will be done daily once the biennial, readiness and other review schedule is established by HHSC leadership. 25%
    • The Registered Therapist V will review the information requested by Acute Care Utilization Review from each MCO to determine if the MCOs policies and procedures are in compliance with the Uniform Managed Care Manual and Uniform Managed Care Contract by completing internal audit tools.

 

    • This employee will oversee the MCOs prior authorization criteria to determine medical necessity is consistent with amount, duration and scope in the Texas Medicaid Provider Procedures Manual and its appropriate application.

 

  • The Registered Therapist V, using clinical expertise, will review each PA request submitted to ACUR to ensure the MCO consistently identified critical elements in the clinical documentation from the provider to establish medical necessity. The Registered Therapist V will analyze if MCOs clinical reviewer appropriately considered the assessment record and plan of care (including but not limited to standardized assessment, functional goals, response to therapy, ABA, custom manual/power wheelchairs) to determine amount and duration by applying the medical necessity as per TMPPM, and other governmental codes and contracts. All the tasks listed below will be done weekly once the biennial, readiness and other review schedule is established by HHSC leadership.
    • The Registered Therapist V will evaluate inconsistency and inaccuracy in utilization review to recommend any findings for process improvement.

 

  • Provides constructive and concise summary input regarding utilization management in discussions of case, policy and procedure reviews with MCO leadership and staff during reviews. All the tasks listed below will be done monthly once the operational, readiness and other review schedule is established by HHSC leadership. 15%

 

    • The Registered Therapist V will plan and prepare for the review of identified cases in coordination with the (therapy) Clinical Review Manager. 
    • The Registered Therapist V will then review the identified casesutilizing the ACUR Tools.
    • The Registered Therapist V will identify and discuss any errors or discrepancies in MCO systems and steps of prior authorization as evidenced in the documentation submitted by MCO.
    • Conducts interviews as needed with utilization management staff members as applicable to overseeing the Utilization management process during reviews.
  • Assists in preparing and disseminating post-review follow-up findings and monitoring MCO activities related to non-compliance with utilization management. The task listed below will be completed monthly after the release of the review schedule by HHSC leadership. 15%
    • Under the direction of the (therapy) Clinical Review Manager, the Registered Therapist V will compile the findings/observations and assist in completing the talking points that will be disseminated to the respective MCOs.
    • The Registered Therapist V will assist in developing and administering input related to the rebuttal, reconsideration processes and Corrective Action Plans (CAPs) submitted by the MCO for approval.

 

  • Administers ACUR clinical and UM review tools competently to ensure accurate and consistent documentation of review findings which includes the review of medical necessity for the deliverance of the requested services. The task listed below will be completed monthly after the release of the review schedule by HHSC leadership. 15%
    • The Registered Therapist V will complete the respective tools, at various stages of a biennial, readiness or targeted review to conduct analysis.

 

  • Develops and provides clinical review of complaints and inquiries, and technical assistance to MCOs and Independent Review Organizations by analysis of clinical documentation. Prepares written report of findings. This task will be done on an as needed basis. 10%
    • The Therapist will receive the complaint from the Quality Assurance team within UR.
    • The Registered Therapist V will review the submitted clinical information to assess the appropriateness of the MCOs determination by evaluating the documentation against the TMPPM, and the MCO’s internal policies and procedures.
    • The Therapist will confer with HHSC’s Assistant Medical Director or Medical Director if needed.

 

  • Interprets complex state and federal laws, regulations, and rules related to Texas Medicaid Managed Care in the process of review and provide subject matter expert input for proposed regulatory changes. This will be completed daily. 10%
    • The Therapist will review, analyze and interpret state and federal laws including but not limiting to TMPPM, UMCM, UMCC, Code of Federal Regulations, Texas Insurance Code, Texas Administrative Code.

 

  • Provides consultation through evaluation and analysis as a specialty area subject matter expert for the various activities to include: contract procurement activities throughout the life-cycle of Texas Medicaid managed care contracts; training and guidance to internal and external staff, informs and collaborates with internal divisions regarding outcomes. This will be completed on an as needed basis.5%
    • The Therapist will review and analyze documents related to Requests for Procurement, clinical policies, as needed.
    • The Therapist will write notifications for providers in collaboration with other departments of HHSC if needed, regarding clarification of clinical policies.
    • The Therapist will lead and participate in provider, inter- and intra- departmental trainings, as needed.
  • Other duties as assigned. (5%)

Registrations, Licensure and Certification Requirements:

Must possess a current Texas Speech Language Pathology license.

 

Initial Screening Criteria:

Master's degree in speech-language pathology required.

Minimum 10 years experience in a clinical setting required. 

Experience with at least one of the following: Texas Medicaid, managed care, utilization review experience in authorization of clinical services, or case management.

 

Knowledge, Skills, and Abilities:

  • Knowledge of Texas Medicaid policy related to skilled therapy benefits.
  • Experience with therapy PA/authorization and utilization management; therapy practice guidelines; therapy quality assessment, assurance, or improvement; therapy research.
  • Knowledge of HHSC programs including Medicaid/CHIP and managed care.
  • Familiarity with ICD-10 and HCPCS/CPT codes.  
  • Excellent computer skills, including Microsoft Office suite.
  • Ability to work independently and function effectively as a member of a team, and under tight deadlines with high volume.

       

 

 

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

 

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

 

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

 

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework.  Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.


Nearest Major Market: Austin

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