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JOB PURPOSE: The Behavioral Health Case Manager, as part of the patient care team, provides direct case management of all assigned patients; thereby contributing to the improvement of patient care, their quality of life, and treatment compliance by the patient. The Behavioral Health Case Manager serves as a liaison and advocate for the patient and family, ensuring the delivery of quality and timely services to the patient from the patient care team and collaboration with community agencies.

The primary goal of the Elk Ridge Community Health Behavioral Health - Case Manager is to support Elk Ridge’s Mission of providing comprehensive, quality health care that is affordable and accessible to all who may have healthcare needs, by successfully performing the primary essential functions.

The following functions and responsibilities will contribute to Elk Ridge Community Health to achieve its KEY RESULTS:

1. World Class Experience for staff and patients
2. Healthier patients and employees
3. Positive Financial Result

Job Functions:

• Provides supportive case management to patients actively enrolled in behavioral health services. Case managers are responsible for monitoring the patient’s current needs, services required to address those needs, and progress in achieving goals or desired outcomes through regular and ongoing contact with patients. Provides optimal patient care by effectively utilizing case management services to coordinate with clinical team members and ensure that effective patient care services are provided to patients with behavioral health needs.
• Depending on the assigned primary duties, case managers will have an expected amount of daily encounters with patients providing case management activities such as the following but not limited to:
•  Assistance in identifying, implementing, maintaining, monitoring, and/or modifying behavioral health services on a routine basis.
• Providing necessary resources that support activities of daily living and/or respond to the needs of other Social Determinants of Health (SDOH) other than behavioral health services.
• Coordination of care activities related to ensuring continuity of care between levels of care, community resources, other natural support systems and health plans.
• Outreach and follow-up care to patients after reporting of a crisis event and/or a missed appointment.
• Participation and engagement in formal and informal case staffing, case conferences, and other meetings as needed for the patient.
• Cultivates advocacy in the delivery of integrated care to patients.
• Utilize internal and external resources to include government social services, community agencies, program requirements, policies, and procedures to effectively support the recruitment, registration, enrollment, and retention of consumers to the Affordable Care Act (ACA) Marketplace, Arizona Health Care Cost Containment System (AHCCCS), or discount programs.
• Receive clinical oversight and supervision by a Behavioral Health Professional at least once every two weeks as specified by regulatory requirements.
• Initiates referrals and supports transitions to requested services in the community or internally as needed.
• Provides triage and navigation to specialized behavioral health resources both internal and external to the organization, in a safe and appropriate manner, staffing cases as necessary with licensed behavioral health professionals and/or with supervisors when needed.
• Performs duties, tasks, assignments, and supports the delivery of quality comprehensive case management and patient care within established time frames; meeting established rates of performance for the quality and quantity of work for the position; demonstrating a level of quality, efficiency, and accuracy in the employee’s job performance that ensures the highest standards of excellence.
• Always maintains patient confidentiality by controlling the information being disclosed to authorized individuals ensuring compliance with all Health Insurance Portability and Accountability Act (HIPAA) and corporate compliance standards, as well as generally accepted confidentiality standards.
• Provides a continuum of professional case management services including comprehensive intake/annual assessments, symptom screening, treatment goal planning, collaborating with care teams, implementing, monitoring, and identifying patient needs for any risks resulting in crisis interventions.
• Upon any new patient assignments, the case manager will complete all required documentation and will continually audit patient charts to ensure all required forms and clinical documents are completed and remain in compliance.
• Coordinates a collaborative and thorough intake service resulting in effective utilization of behavioral health and integrated services.
• Provides on-going supportive case management functions in accordance with the patient’s presenting problems, needs, and strategies identified within the service plan in order to help the patient to achieve the stated goals and objectives.
• Provides treatment adherence support and education for patients that are currently receiving medication management services from behavioral health medical providers.
• Maintains regular contact with enrolled patients to monitor progress towards treatment goals, modify treatment plans as clinically necessary, and facilitates treatment care meetings with patients, treatment team, and any natural supports as requested by the patient.
• Participates as a team member of the clinical interdisciplinary team to ensure appropriate care, support, and resources to all internal/external patients, displaying ongoing commitment to quality of care.
• Functions as a principal team member in the interdisciplinary team, which consists of the patient’s behavioral health provider, primary care medical provider, nurse support and case management and coordinating treatment planning and care plans, hospital discharge coordination, and assistance when a patient needs to be transferred to another agency and service type.
• Ensures that patient care is documented accurately and in a timely manner and meets all regulatory standards, guidelines, and established criteria.
• Develops and maintains positive and effective working relationships with patients, family members and clinical staff, as well as administrative and support team members to foster professionalism and coordination with the patient care team.
• Works with patients and family members to answer questions, provide emotional support, and resolve issues or problems concerning the linkage to and coordination of patient care and services.
• Serves as an effective communication link between the patient and medical/behavioral health staff, relaying messages, or requests to or from providers, and gathering information from patients.
• Receives and responds to non-appointment related calls from patients; resolves the issues and reasons for the call and/or routes the request to the appropriate party.
• Understanding of government and community social agencies and services to effectively coordinate referrals to supporting services for patients in need.
• Maintains information and resource listings regarding the environment of support and social services to ensure a flexible, responsive, and culturally competent patient care service.
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• Comprehensive understanding of applicable Federal, State, and commercial requirements, standards, regulations, and laws; as well as all organizational policies and procedures related to behavioral health services.

Joint Commission Responsibilities:

• Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures including but not limited to work areas, workstations, examination rooms, hand washing, infection prevention and control etc. for this position.
• Demonstrates an understanding of and proficiency with the application of all compliance and reporting requirements respective to Joint Commission Certification (JCC) standards.

Other Duties and Responsibilities:

• In support of the Mission and Vision of Elk Ridge Community Health, will at all times represent themselves as a professional role model of Elk Ridge Community Health serving as a positive informational source for members of the community.
• Supports Elk Ridge Community Health by participating in community events which promote good health, and which contribute to a broader awareness and understanding of Elk Ridge Community Health and the many services provided to the community.
• Participates in all appropriate health care activities related to Elk Ridge Community Health on a local, state, and national level to maintain and enhance Elk Ridge’s image with health agencies, professional associations, and the general public.
• Ensures and supports the cost-effective use of materials, supplies, and equipment by limiting waste of all organizational supplies and resources.
• In accordance with policies and procedures ensures that documentation of hours worked is completed accurately, as well as signed-off/approved in a timely manner.
• Employees must maintain their skills proficiency with Elk Ridge Community Health operating systems and/or software programs by adapting to changing requirements and successfully learning and demonstrating new skills in response to software, system, and program improvements or upgrades.
• Performs other duties as assigned.

Qualifications:

Minimum Qualifications

Details

Education

Bachelor’s Degree in Social Work, Psychology, Sociology, Public Health or a related field from an accredited college or university.

Experience

One (1) year of experience working in human services, behavioral health, or case management, preferably in a healthcare environment.

BLS

Current certification in Basic Life Support (BLS) for health care providers

Fingerprint Clearance Card

Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment

If applicable, equivalent combination of education and experience may be considered, and must be directly related to the functions and responsibilities of the job.

Preferred Qualifications

Experience Details

Education

Master’s Degree in Social Work, Psychology, Sociology, Public Health or a related field from an accredited college or university.

Experience

Three (3) years of experience working in human services, behavioral health, or case management, preferably in a healthcare environment.

Bilingual (English/Spanish) with the ability to speak, read and write in both languages.

Transportation:

• Employees in this position are required to have reliable transportation that can meet any operational reassignments of the organization during the workday. If an employee is driving during work hours, the employee is required to possess a valid driver’s license and must comply with Arizona vehicle insurance requirements.

Core Competencies:

• Advocate for Patients
• Track Clinical Outcomes
• Compassionate Communication
• Cultural Competence
• Honor Patient Privacy
• Service Recovery

Supervisory Duties:

• None

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Elk Ridge Community Health does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, age 40 and over, disability, genetic information, military status, ancestry, marital status, familial status, or any other status protected by law or regulation.

It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors.

All employees are required to undergo drug testing prior to employment and will be subject to post-accident, reasonable suspicion, return to duty and follow up drug and alcohol testing in compliance with Federal and State regulations for alcohol and controlled substance testing. Employees in positions holding responsibility for the safety and welfare of others will also be classified as safety sensitive.

Elk Ridge Community Health is a Non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and abides by all applicable federal Drug-Free Workplace standards.