POSITION SUMMARY

A Behavioral Health Care Manager provides care management for specified CCBHC patients, Health Center patients, and community members in need of care management at Sun River Health. These patients may be referred by providers/clinical team; enrolled as a Behavioral Health CCBHC Program, be included in care management as part of a grant, insurance program or disease specific program. Links patients to preventive and primary health care services including care for: acute, chronic and communicable diseases; dental services; prenatal care and family planning; WIC and other nutrition services; pediatric care and immunizations; and behavioral health or substance abuse programs as needed. This includes assistance with community resources, social services, and referrals. This position will be responsible for proper and timely documentation within eCW and any designated care management software, as well as communication with internal and external referral sources to capture services provided. Performs other duties as assigned on an as needed basis. The position is full-time and will be supporting our Inwood and The HUB locations.

ESSENTIAL FUNCTIONS

• Responsible for completing outreach and subsequent intake activities using required forms and documents as required. This may include program specific additional consents and assessment tools. Document as directed in eCW and designated program software.
• Consult with multidisciplinary team on client’s care plan/needs/goals. This may include participation in case conferencing. May also include family members and social supports.
• Responsible for referring patients to needed services as directed by provider to support care plan/treatment goals; including medical/behavioral health. Responsible for release of all necessary clinical information to specialist referral; tracks referral appointments and obtain consultant reports with appropriate consent for release of information and documents process in eCW per Sun River Health procedure and designated software for care management.
• Consult with health care team to link patient to community/social services programs and entitlements: including application assistance; transportation assistance; translation services; housing services; self-help recovery and self-management programs as needed. Document.
• Conduct client outreach and engagement activities at least monthly to evaluate for on-going emerging needs and to promote continuity of care and improved health outcomes. Document.
• Follow up with Hospitals/ER upon notification of admission or discharge and coordinate with health care team to facilitate communication of the event and transition of care services, to include, but not limited to medication reconciliation with the health care team as per policy.
• Assist patient in developing plans and community supports to overcome obstacles that would prevent them from receiving needed services/referrals.
• Provide basic instruction/health education to clarify provider instructions, procedures and referral needs.
• Conduct field visits to coordinate the care of patients.
• Participation in Behavioral Health CCBHC events to support services provided to patient populations and community members.

The above is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of the job. It is not to be construed as an exhaustive statement of all the job functions

EDUCATION/EXPERIENCE:

Associate degree or bachelor’s degree in Social Work, Counseling, Psychology, or related field as recognized by the US Department of Education. At least 2 years’ experience in the social services field is preferred. Bilingual English/Spanish preferred, but not required.

LANGUAGE SKILLS:

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

MATHEMATICAL SKILLS:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

EVALUATION METHODOLOGIES:

This position will be evaluated based on the incumbent’s ability to prioritize, time management skills and flexibility. In addition, the incumbent’s performance will be measured and evaluated according to the standardized tool used for all employees providing service to internal and external customers and incorporating Sun River Health’s Core Values.

REASONING ABILITY:

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

CERTIFICATES, LICENSES, REGISTRATION:

Licensed to practice as a NYS Social Worker with certification as an LCSW, LMSW, or LMHC is preferred

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Visual acuity and manual dexterity to interface with the computer and perform medical procedures as indicated. Auditory acuity to handle phone calls and interact extensively with patients.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SAFETY & SECURITY:

All workers are under obligation to follow rules and regulations pertaining to safety and security. Failure to comply with safety & security rules and regulations will result in disciplinary action up to and including termination of employment.

Hourly Range: $23.00-$28.75/ hour