The Community Outreach Care Extender provides support to the Population Health Department. This individual will understand and adhere to contractual requirements while assisting the team in reaching outcome goals.
The associate will have access to sensitive patient information and must maintain the integrity of those records at all times. The individual must be trustworthy, have a flexible schedule, have a hands-on approach to details, excellent organizational skills with a strong attention to detail and be a team player.
- Initial outreach and engagement to a cohort of members
- Continuous outreach and engagement on a regular basis (as contracted)
- Develops and coordinates community resources with emphasis on medical, behavioral, violence prevention and social services.
- Assess clients for risk, make quick evaluations for risk, and respond within the parameters outlined within their safety plan, formulating, and performing crisis intervention the ensures the safety of clients as necessary.
- Assess the options for care including use of benefits and community resources to develop and update the care plan.
- Guide clients in the development of skills and/or strategies for managing problems and triggers to increase relapse prevention and reduce risk.
- Encourage clients to develop work skills and to participate in social, recreational, or other therapeutic activities that enhance interpersonal skills and develop social relationships.
- Educate clients about mental or physical illness, abuse, violence prevention, medication, and available community and social resources.
- Schedule or facilitates scheduling appointments and follow-up services.
- Schedule or facilitates scheduling appointments to conduct assessments or face to face visits in the community as needed.
- Monitor, evaluate, and record clients’ progress according to measurable goals described in clients’ plan.
- Acts as liaison and member advocate between the member/family, physician and facilities/agencies.
- Contacts members to remind them about upcoming appointments and/or missed appointments.
- Interacts continuously with member, family, physician(s) and other providers utilizing clinical knowledge and expertise to lower over-utilization of unnecessary resources.
- Requests consultation and diagnostic reports from network specialists.
- Reports critical incidents and information regarding the quality of care issues.
- Reporting and Documentation:
- Prepare and maintain all required records, reports, paperwork, and clients’ diagnostic records, maintaining confidentiality of clients at all times.
- Develop and implement modifications to clients’ plan based on clinical experience and knowledge and in response to changes in clients’ status, as requested and no less than once every three months.
- Use clear and accurate communication skills (both verbal and written) to facilitate communication with the clients, clients’ family/caregivers, with staff, and treatment team; produce high quality documentation that enables the clients to receive the best treatment possible.
- Maintains accurate records of case management activities in the Mindoula Admin System.
- Accurately complete all case notes in a professional, timely manner.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
- Use creative methods to locate members for engagement
- Complete short-term projects with tight deadlines.
- Adhere to rigorous client record keeping data entry and standards and procedures.
- Competently relate to clients, their families, and agencies involved with clients through above average interpersonal skills.
- Uphold professional standards as a representative of Mindoula Health.
- Improve our program and work environment through constructive suggestions and show each individual respect and compassion without crossing therapeutic boundaries, infringing on ethical standards, or being drawn into unethical situations.
- Work as part of the clinical team; promote teamwork and unity.
- Respond positively to supervision and to recommendations for improved performance.
- Promptly notify supervisor of planned and unplanned absences or late arrivals.
- Work under high stress with multiple priorities maintaining the ability to respond to clients and their support systems in a healthy manner.
- Relate to clients in a non-threatening manner that is not rude, impersonal, or degrading to the client.
- Establish appropriate boundaries with each client that encourages his or her growth but does not foster dependency.
- Utilize a high degree of independent judgment while working with clients and their support system.
- Keep current of evolving research, techniques, and skills that will improve intervention with clients.
- Participates in a biweekly staff meeting and individual meeting with supervisor
- Performs special projects as assigned.
Required Education and Experience
- BA Degree minimum.
- Master Degree Preferred
- Two (2) years of direct experience in the field.
- Knowledge of Resources, Social Determinants of Health, Mental Health, Substance Abuse Disorders, Violence, and social issues.
- Excellent computer skills and experience with Google Suite software (Google Sheets) and Microsoft Office software (Excel).
- Strong data entry skills.
- Must be detail-oriented and able to multitask.
- Excellent oral and written communication skills.
- Must be able to work in a fast-paced environment and have a strong sense of urgency.
This position has no supervisory responsibilities.
This position requires travel within a 60-mile radius of the office, therefore, requires the candidate owns a vehicle.
We launched Mindoula because each of us has had personal experience with mental illness, either directly or through a loved one. We realized that the behavioral health system was broken and decided to take it upon ourselves to fix it by focusing on the people we serve, not their diagnoses or symptom sets. Each of us, and everyone we serve, is a person first, and a set of challenges second.
We address the full range of behavioral health challenges. We deploy tech-enabled teams of case managers, care managers, community health workers, peer support specialists, and psychiatrists to provide 24/7 support to even the most complex and underserved behavioral health populations. Our member engagement and predictive analytics technology platform has made the company a market leader in hospital re-admissions reduction, collaborative care, care coordination for the seriously mentally ill, and measurement-based psychiatry.