Targeted Case Manager - Adult Outpatient Services

Job Description

Job Description

Job Summary

Targeted Case Manager serves individuals with mental health and substance use disorders who require assistance to gain access to necessary care: medical, behavioral, social, and other services appropriate to their needs. Services include case management assessment; person centered planning, referral and linkage, monitoring and follow-up. If position is assigned to serve a specific population, agency location, or to staff an enhanced service such as Integrated Classroom, Family Safety Program, Juvenile Services, Kanvwotiyi, MAT, etc., specific policies and procedures will apply.

Essential Duties and Responsibilities

Direct Service Duties

• Provide the following case management functions according to CIHA policy: case management assessment; person centered planning; referral and linkage; and monitoring and follow-up.
• Maintains caseload by identifying new patients assigned in a timely manner and discharging patients according to CIHA policy and procedures.
• Provides documentation of all treatment and clinically significant events in Electronic Health Record as prescribed by CIHA policies and procedures and quality assurance standards.
• When assigned to provide services for adults, or for children and families, the employee will fulfill duties as outlined in CIHA policy and procedure related to the specific population served.
• Gather and document necessary information in the EHR including medical, physical and functional, psychosocial, behavioral, financial, social, cultural, environmental, legal, and vocational or educational areas.
• Engage patients in the person centered planning process to assist them in obtaining the outcomes, skills, and symptom reduction they desire.
• Link clients to needed services and supports.
• Provide timely information to treatment team members regarding client status, progress and safety. Utilize judgment in carrying out CIHA policy for risk assessment and crisis intervention.
• Collaborate with the medical staff and other health professional/agencies to facilitate patient care, discharge and follow-up.
• Provide consultation to patient and family in matters directly related to patients' limitations, finances, adjustments to medical condition and ongoing treatment.
• Work with internal and external providers to coordinate discharge planning, follow-up care, and transfers to other behavioral health facilities as appropriate.
• Responsible for attending clinical staffing as an integral component of a treatment team, facilitating the discussion of client data, and formulating changes to the treatment plan.
• Participate in meetings to review and identify opportunities to improve the program and treatment provided, and support the team in problem solving when concerns are identified.
• Provide written, telephonic and face-to-face consultation services to various persons and organizations which affect the patient. These include schools, courts, probation officers, physicians, hospitals, medical care providers, law enforcement officers, social services, community agencies, etc.
• Provide support to patients in the office setting as well as the community setting by conducting home visits with patients and collaterals as needed.
• Represents CIHA at regular team meetings for progress review and during emergency meetings dealing with high-risk situations.
• Participate in community planning and implementation of programs to help resolve related to client care.
• Collect and report on data necessary for client care according to procedure and as directed by supervisor.
• Expected to obtain continuing education both through in-service training and through access and tuition payment for approved training seminars and workshops.
• Other duties as assigned.
• Support the Tribal Option Care Managers as needed.

Education/Experience/Minimum Qualifications

Qualified Professional (QP) “Qualified Professional” within the mental health and substance abuse system means:

• Individual who holds a license, provisional license, certificate, registration or permit issued by the governing board regulating a human service profession, except a registered nurse who is licensed to practice in the State of North Carolina by the North Carolina Board of Nursing, who also has four years of full-time accumulated experience in MH/SA with the population served; or
• Graduate of a college or university with a Master’s degree in a human service field and one year of full-time, pre- or post-graduate degree experience with the population served or a substance abuse professional with one year of full-time, pre- or post-graduate degree accumulated supervised experience in alcoholism and drug abuse counseling; or
• Graduate of college or university with a bachelor’s degree in a human service field and two years of full-time, pre- or post-bachelor’s degree experience with the population served or a substance abuse professional who has two years full-time, pre- or post-bachelor’s degree accumulated supervised alcoholism and drug abuse counseling; or
• Graduate of a college or university with a bachelor’s degree in a field other than human services with four years of full-time, pre- or post-bachelor’s degree accumulated MH/SA experience with the population served.
• This category includes Substance Abuse Professional, Certified Alcohol and Drug Counselors (CDAC), Certified Clinical Supervisor (CCS), Licensed Clinical Addictions Specialist (LCAS
• Must possess valid drivers' license.
• Specific experience working with Native Americans preferred.

Job Knowledge

• Knowledge crisis intervention with individual and families experiencing acute episodes of distress.
• Ability to ascertain the potential lethality of a situation and respond and refer accordingly.
• Ability to learn computerized treatment systems such as EHR, and ability to maintain records and files manually and on the computer.
• Originality and initiative are required in the daily performance of tasks.
• Knowledge of principles, techniques, and practices, and their application to complex casework, group work, and community problems.
• Knowledge of a wide range of medical, behavioral and psychosocial problems and linkage to treatment.
• Knowledge of governmental and private organizations and resources in the community.
• Knowledge impact of mental illness on patient’s ability to negotiate treatment recommendations, current treatment approaches, modalities of care, and substance abuse and other programs or services available to patients.
• Skill in establishing rapport with a patient and in applying techniques of engaging patients.
• Willingness learn more about Cherokee culture/population and to have considerations for this when identified.
• Ability to establish and maintain effective working relationships with patients and their families, other professional disciplines, and a variety of governmental and private resources and organizations in the community.
• Ability to express ideas clearly and concisely and to plan and work effectively in a team.

Complexity of Duties

This position is responsible for assisting in maximizing the available resources that best meets the constantly changing needs of the community. Must have the ability to interpret policy, laws and regulations in order to make decisions when a precedent is not available. Duties require the application of clinical judgment and problem solving skills in order to be effective.

Supervision Received

Works under the direct guidance of the supervisor, manager, and/or behavioral health clinical director where goals, objectives, policies, and procedures are well defined. Works independently within applicable licensing regulations where latitude for creative thinking, initiative and discretion are given to achieve department goals and objectives.

Responsibility for Accuracy

Most clinical errors would be detected with proofing and review procedures. Failure to properly manage and direct activities could result in ill will for the department, delays in patient treatment, and negative patient and community relations. Ineffective health planning could have adverse effects on the health status of the community by limiting access to necessary resources. Accuracy of data and research is critical in the allocation of tribal resources. Responsible for the adherence to policy and procedure. Inappropriate actions or inaccuracies in judgment could result in improper diagnosis and treatment, serious liability for the tribe, or more serious health risks to patients.

Contacts with Others

Interacts frequently with coworkers, hospital staff, patients, stakeholders and other health professionals for the purpose of exchanging information, obtaining, or providing assistance. Serves on various local, community, and health committees, boards and advisory councils, as appropriate. Tact, courtesy, and professional conduct are required to maintain positive working relationships. Utmost sensitivity and confidentiality is required when dealing with patients and families.

Confidential Data

The provision of medical care requires that the incumbent maintain strict appropriate confidentiality regarding all patient information. The employee will have access to patient records and highly confidential information and must function with utmost integrity to safe guard this information. The employee complies with EBCI policy on confidentiality of patient records, Cherokee Indian Hospital Authority Confidentiality policy, HIPAA, 42CFR and other federal law requirements. Violations of confidentiality regulations may result in disciplinary action and other action as allowed by federal regulations.

Mental/Visual/Physical Environment

Job duties can be mentally and emotionally stressful at times given the complexity of the duties, management and supervision of staff and the clinical areas being addressed with the people being served. Close mental concentration and attention to detail are required. Physical activities require the ability to be mobile, sit, reach, bend, and be in front of groups and deliver training for extended periods of time. Some physical exertion and stamina is required such as required to transport training materials or to travel. Must have visual acuity, manual dexterity, and the ability to speak and hear. Must be able to lift 30 lbs.

• Position requires: stand (under 1/3 time); walk (under 1/3 time); sit (to 2/3 time); talk or hear (over 2/3 time).
• Weight lifted or force exerted: none.
• Special vision requirements: Close vision (clear vision at 20 inches or less).

Work Environment

The employee works primarily in a hospital, inpatient or outpatient clinical environment and the community but may be required to work at other offices and locations. The work environment involves moderate risks of exposure to infectious disease, radiation, electrical hazards, and irritant chemical and explosive gases. Employee must strictly adhere to OSHA guidelines and protocol for maintaining sterile conditions. Some travel is required. Infrequent overnight travel may be required for meetings or to attend training.

Customer Service

Consistently demonstrates superior customer service skills to patients/customers by demonstrating characteristics that align with CIHA’s guiding principles and core values. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.