Social Worker Care Manager

About the role

The owns the comprehensive assessment and clinical oversight of patient mental health and substance abuse needs within the assigned Waco caseload. This role owns the systematic tracking of treatment response and symptom changes through in-person or telephonic monitoring to ensure accurate clinical documentation. The hire will own the facilitation of psychotropic medication management discussions and translate behavioral health consultant recommendations to the primary care provider. They own the provision of evidence-based brief interventions such as motivational interviewing and problem-solving treatment to support patient engagement. This position owns the coordination of in-clinic and external referrals for psychosocial services and community resources as clinically indicated. The Social Worker Care Manager owns the development of relapse prevention plans for patients achieving treatment goals and preparing for discharge. They are responsible for utilizing Excel and Word competencies to complete daily assessments and productivity tracking with accuracy. Finally, this role requires ownership of time-management and effective calendar use within the EMR system to balance telephonic and in-person visit responsibilities.

Key facts

What you'll do

• Support the mental and physical health care of patients on an assigned patient caseload.
• Screen and assess patients for common mental health and substance abuse disorders and facilitate patient engagement and follow-up care.
• Provide patient education about common mental health and substance abuse disorders and the available treatment options.
• Systematically track treatment response and monitor patients (in person or by telephone) for changes in clinical symptoms and treatment side effects or complications.
• Support psychotropic medication management by consulting with the behavioral health consultant and then communicating with the primary care provider assigned.
• Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate.
• Provide or facilitate in-clinic or outside referrals to evidence-based psychosocial treatments (e.g. problem-solving treatment or behavioral activation) as clinically indicated.
• Participate in regularly scheduled (usually weekly) caseload consultation with the psychiatric consultant and communicate resulting treatment recommendations to the patient's medical provider.
• Track patient follow up and clinical outcomes using a registry and document in-person and telephone encounters in the registry to identify and re-engage patients.
• Document patient progress and treatment recommendations in EHR and other required systems so as to be shared with medical providers, psychiatric consultant, and other treating providers.
• Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant and who may need more intensive or more specialized mental health care.
• Facilitate referrals for clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).
• Develop and complete relapse prevention self-management plan with patients who have achieved their treatment goals and are soon to be discharged from the caseload.
• Be comfortable utilizing Excel and Word and completing assessments and productivity trackers daily.
• Time-management skills are a must and the BHCM needs to be able to manage their day effectively through calendars and the EMR system.
• This role is telephonic, however in person visits are done and the BHCM has to be comfortable completing them both ways.

Requirements

• The Social Worker Care Manager will have a minimum of MSW.
• Preferred Licensure or provisionally licensed.
• Behavioral Health experience and knowledge.
• Must be licensed driver with an insured automobile in good working order.
• Ability to communicate effectively, both verbally and in writing.
• Time Management skills.

Practical notes

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Engagement: Full-time.

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Location: Waco, TX.

• This role is telephonic, however in person visits are done and the BHCM has to be comfortable completing them both ways.
• No specific visa or deadline details are provided in SOURCE.

Compensation

(Compensation details were not provided in SOURCE.)