Case Manager-MHA

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Job Title: Case Manager - QMHP-CS

Adult Mental Health Services - Office Based

Primary Function:

Provide Rehabilitative Case Management (RCM) for patients of the Gulf Coast Center (GCC).  Primary responsibility will be coordinating and implementing services using the Texas Resiliency and Recovery (TRR) model.  This model incorporates resiliency and recovery oriented services, supports, practices and beliefs into publically funded mental health delivery systems. As part of an interdisciplinary team, and within the scope of the team, the RCM staff will be responsible for consultation with other team members on RCM issues; developing full range of options in the community settings; rehabilitation self management and wellness strategies; coordinating medical documentation within medication visits for GCC patients, and technical assistance as part of the team in an individual and/or group capacity.

Secondary Function:

Provide initial screenings, assessments, and eligibility services to potential patients of the Gulf Coast Center.  Responsible for providing brief interventions such as crisis resolution, skills training and education, case management, and liaison between other programs and organizations.  Services may be provided through telephone, face-to-face, or teleconference contacts.  Staff will present cases to telemedicine providers and ensure that orders and follow-up are completed. Receives programmatic oversight from the Utilization Manager.

Supervision

Receives direct supervision from the assigned service site Program Manager and programmatic oversight from the Utilization Manager. 

Education

Requires a bachelor's degree or equivalent in the behavioral sciences field of study from an accredited college or university and/or specialized QMHP certification.

Experience

Two to three years full-time experience in human services preferred. 

Ability

  • General knowledge of mental disorders.
  • Self motivated with good time management skills.
  • Good interpersonal skills.
  • Must have a demonstrated ability to work with a variety of office & video equipment and office software.
  • Needs to establish cooperative relationships and work with individuals seeking services, other professionals, and organizations.  Knowledge of local social service network.
  • Mature problem solving approach to daily work.
  • Ability to express self clearly and effectively, orally and in writing.
  • Demonstrated ability to work within a team approach.
  • Demonstrated PC skills, to include proficiency in navigating SmartCare EHR.

Status

  • Non-exempt under Fair Labor Standards Act.

Working conditions

  • Majority of work is in the office setting.
  • May require irregular work hours.
  • May periodically transport consumers in personal and/or Gulf Coast Center Vehicle.
  • Requires current Texas Driver's License, reliable transportation safe and current with all State requirements, and liability insurance.
  • Out of region travel may be required.

JOB DUTIES/PERFORMANCE STANDARDS

Treatment Team Member (Essential)

Primary Function:

  • Identifies a current and discreet caseload as part of an interdisciplinary team.
  • Serve as a member of the treatment team coordinating and providing services as needed.
  • Actively participate in team meetings as evidenced by discussion that is not only specific to assigned caseload.
  • Display professionalism and team membership when representing program.
  • Personnel vacancy may result in temporary increase of caseload.
  • Maintain contact with designated staff on a daily basis regarding current work area and retrieval of messages.

Secondary Function:

  • Provide initial screening in person, over the telephone, or televideo.
  • Conduct an intake interview and appropriate assessments to gather required information.
  • Coordinate and track patient workflow.
  • Do crisis screening to determine level of risk.
  • Completes referrals to internal/external resources as clinically indicated.
  • Conduct drug screenings as needed.
  • Coordinates with Patient Services Specialist for completion of financial screenings.
  • Coordinates with Eligibility Advisor for completion of benefits screening & Medicaid application where applicable
  • Develops person-centered recovery plans based on patient's needs and preferences.
  • Presents patient cases to prescribers.
  • Makes appropriate referrals to community and Center services.

Rehabilitative Treatment Provider (Essential)

  • Provides RCM self management strategies and clinical coordination to individuals, groups, and family members as defined by GCC using evidence based strategies within the (TRR) model of care. 
  • Provides crisis services to patients and walk-ins to the clinic as needed.
  • Provides monthly documented face to face hours of direct service per month to GCC consumers and/or family members as indicated in the current Direct Service Agreement for this position. 
  • Monitors patients' requirements within the TRR model to ensure required services are offered and meeting targeted monthly service provision standard for identified caseload.
  • Assure treatment provided to patient relates to the individualized goals of treatment plan.
  • Utilizes a variety of skills training methods to include areas such as introduction, role play, behavioral reversal, in-vivo practice, and coaching.

Billing/Documentation (Essential)

  • Enters accurate and appropriate RCM billing and documentation into SmartCare EHR within 2 business days of service provision as appropriate to patients' treatment plan and assignment in SmartCare. 
  • Maintains compliance with all documentation for patients as assigned and as required by the GCC policies and procedures within caseload.
  • Conducts the Adult Needs & Strengths Assessment (ANSA) every 6 months or as clinically indicated for individuals as required & assigned.  Responsible for ensuring staff completion of initial & annual ANSA recertification pursuant to the Praed Foundation & HHSC performance contract.  A lapse/expiration in certification will result in termination of employment. Exception:  If certification lapse/expiration is reported to supervisor within 24 hours of expiration date, employee will be granted opportunity to recertify by close of following business day.  Any lapse/expiration greater than 24 hours will result in termination of employment. Additionally, all certified practitioners are responsible for participating in semi-annual quality assurance training activity conducted by the identified ANSA/CANS Super User
  • Participate in Medicaid Administrative Claiming (Random Moment in Time) process.
  • Through a system of care, helps to establish baseline data & assists with tracking vital health indicators as a part of BHCQMs & 1115 Waiver outcome measures.

Training (Essential)

  • Maintains as current all levels of training as directed by GCC.

Corporate Compliance (Essential)

  • Strict adherence to the professional, ethical, and legal requirements set forth in the Center's Business Code of Conduct as well as the Corporate Compliance Plan.
  • Strict adherence to authorizations and to all GCC policy guidelines outlined in GCC medication transport guidance letter when there is a need to transport patient medications. 

Special Projects (Essential)

  • Assist supervisor when requested to complete special projects and completes all assignments within a time frame negotiated with the supervisor.
  • Other tasks as assigned by manager within scope of Center & job position.