Targeted Case Manager - MAT

Job Description

Job Description

Job Summary

Targeted Case Manager serves individuals with mental health and substance abuse 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. The Targeted Case Manager will follow specific policies and procedures for the Family Safety Program and Family Intensive Treatment.

Essential Duties and Responsibilities

Direct Service Job Duties

• Provide the following case management functions according to CIHA policy and procedure and DMA Clinical Coverage Policy 8L : case management assessment; person-centered planning; referral and linkage; and monitoring and follow-up.
• Provides documentation of all treatment and clinically significant events in the Electronic Health Record as prescribed by CIHA policies 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.
• When assigned to provide case management services for clients in the Buprenorphine Clinic, the employee will fulfill duties as outlined in CIHA policy and related procedures.
• Gather and document necessary information, including medical, physical and functional, psychosocial, behavioral, financial, social, cultural, environmental, legal, and vocational or educational areas.
• Develop a person-centered treatment plan which incorporates what is important to and for the client, and which is geared to achieve clinical outcomes.
• 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.
• Develop and implement discharge plans, follow-up care, and transfers to other behavioral health facilities as appropriate.
• Implement and follow the provisions contained in all applicable privacy / confidentiality policies, procedures, and practices for maintenance and release of patient records and clinical information, including EBCI, CIHA, IHS, DHHS, HIPPA, JCAHO, CFR 42, or other licensing bodies.
• 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 recommend corrective action when problems are identified. This includes assisting with changes in policy and procedure, which would improve service delivery.
• Assists with changes in CIHA / Analenisgi policy and procedure, as needed.
• Provide written, telephone, and face-to-face consultation services to various persons and organizations that affect the patient. These include schools, courts, probation officers, physicians, hospitals, medical care providers, law enforcement officers, social services, and community agencies.
• 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 such complex issues as improving coordination of services or developing programs to serve the community.
• 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.
• This position may be expected to provide sufficient billable / reimbursable Targeted Case Management services to achieve the productivity standard established for areas of responsibility if needed. this position. Standard is may be based on "actual minutes" billable / reimbursable hours of service provided, divided by available hours in a given period.
• Effectively utilize an electronic medical record and other software required for operation in the CIHA system
• This position may require support to CIHA primary care nurse care managers as defined by standards set for specific populations.
• Other duties as assigned.

Education / Experience / Minimum Qualifications

“Qualified Professional” means within the mh / dd / sas system of care :

This category includes Substance Abuse Professional, Certified Alcohol and Drug Counselors (CDAC), Certified Clinical Supervisor (CCS), Licensed Clinical Additions Specialist (LCAS)

Job Knowledge

Complexity of Duties

This position is responsible for assisting in maximizing the available resources to develop and maintain behavioral health services for EBCI children and families 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 judgment and problem solving skills in order to be effective. Judgment often involves decisions that may have life or death results. At times may be dealing with individuals who are highly agitated, emotional, or out of touch with reality.

Supervision Received

Works under the direct guidance of the Adult TCM supervisor, Medication Assisted Treatment 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

Errors should be identified and corrected in a timely manner Failure to properly document, convey or interpret clinical data can adversely impact client care. 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. Employee is responsible for adherence to policy and procedure. Inappropriate actions or inaccuracies in judgment could result in improper diagnosis and treatment, serious liability for CIHA, or more serious health risks to patients.

Contact with Others

Interacts frequently with coworkers, hospital staff, patients, and other health professionals for the purpose of exchanging information, obtaining, or providing assistance. Employee may serve on 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, and other federal law requirements. Violations of confidentiality regulations may result in disciplinary action and other action as allowed by federal regulations.

Emergency Privileges

In the case of an emergency, any member of the Medical Staff, to the degree permitted by his / her license shall be permitted to do everything possible to save a patient’s life or save a patient from serious harm, regardless of the individual’s clinical privileges. This shall be defined as those situations in which a delay could result in serious harm or death and in which a more qualified member is not immediately available.

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.

Work Environment

The employee works primarily at the PHHS building with occasional service provisions in the community, at the hospital, inpatient or outpatient clinical environment but may be required to work at other offices and locations as needed. The work environment involves moderate risks of exposure to infectious disease, radiation, electrical hazards, 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.