Behavioral Health Care Manager

Overview

OHSU Family Medicine at Richmond is designated as a Federally Qualified Health Center (FQHC) and cares for over 16,000 community members as a part of the community safety net. Some applicants may qualify to apply for student loan repayment due to FQHC designation.

The behavioral health care manager (BHCM) position is a behavioral health provider who operates in the Collaborative Care Model (CoCM) as part of our integrated behavioral health teams. The behavioral health care manager is a core member of the CoCM team, including the patient’s medical provider (primary care provider, or referring specialty provider) and psychiatric consultant, traditional health care worker (THW) if available, as well as the larger clinic team to ensure continuity of care. The BHCM is responsible for supporting and coordinating the mental and physical health care of CoCM patients on an assigned patient caseload with the patient’s primary care provider and the CoCM psychiatric consultant. When appropriate, the BHCM may also coordinate care with other internal and external mental health providers.

This position involves a high degree of clinical complexity and advanced level of skill in delivering evidence- based interventions targeted to improve wellbeing and health for a large variety of patients with emotional and behavioral concerns commonly seen in a primary care setting. The work includes screening and assessing patients for common mental health and substance use disorders, providing education about these conditions, discussing available treatment options, and facilitating patient engagement and follow-up care. The BHCM also is responsible for systematically tracking treatment, engagement, and response (via a registry) and for monitoring patients (either in person, by phone or virtual visit) for changes in clinical status and treatment side effects or complications. The BHCM supports the patient in their management of their psychotropic medication, focusing on treatment adherence monitoring, side effects and effectiveness of treatment.

Additionally, the BHCM provides brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving therapy, motivational interviewing, and other treatments as appropriate. The role also involves participation in regular (weekly) caseload consultation with the psychiatric consultant and communication of resulting treatment recommendations to the patient’s continuity medical provider.

Function/Duties of Position

Counseling:

• Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate.
• Support the patient in their psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
• Provide or facilitate in-clinic or outside referrals to evidence-based psychosocial treatments (., problem-solving treatment or behavioral activation) as clinically indicated.
• Support the mental and associated physical health care needs of patients on an assigned patient caseload. Closely coordinate care with the patient’s continuity medical provider and, when appropriate, other mental health providers.

Psychosocial Assessment:

• Screening and assessment of patients for common mental health and substance use disorders. Facilitate patient engagement and follow- up care.
• Provide patient education about common mental health and substance abuse disorders and the available treatment options.

Patient Services

• Systematically track treatment response and monitor patients (in person or by telephone or virtual visit) for changes in clinical symptoms and treatment side effects or complications.
• Manage collaborative care registry.
• Facilitate referrals for clinically indicated services outside of the organization (., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).
• 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.
• Systematically track treatment response and monitor patients (in person or by telephone or virtual visit) for changes in clinical symptoms and treatment side effects or complications.

Documentation:

• Document patient progress and treatment recommendations in the electronic health record (EHR) and other required systems to be shared with medical providers, psychiatric consultant, and other treating providers.
• Track patient follow up and clinical outcomes using a registry. Document in-person and telehealth encounters in the registry and use the system to identify and re-engage patients.
• 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.

Required Qualifications

• A Master’s Social Work (MSW) required. Health care experience preferred.

• Certificate of Clinical Social Work Associate (CSWA) or Licensed Clinical Social Worker (LCSW) required for employees who practice clinical social work.

• Must possess a valid motor vehicle driver license in good standing and must be eligible to operate a motor vehicle owned by OHSU or other agency; or demonstrate the ability to access transportation to meet the requirements of the position.

• BLS/CPR certification within 6 weeks of hire.

Job Related Knowledge, Skills, and Abilities (Competencies):

• Experience in behavioral health counseling and brief short-term therapy strategies, and case management is required.
• Demonstrated commitment to valuing diversity, equity and inclusion in the clinic and learning environment.
• Ability to contribute to the success of the organization through support of and seeking out diversified ideas and perspectives.
• Ability to utilize assessment information and collateral information to conceptualize patient psychopathology.
• Skill and expertise in conducting group and individual psycho-educational classes and brief, short-term therapy strategies that will help strengthen the patient's overall physical and mental health. Incorporation of self-management, home-based practice in care planning.
• Skill in efficiently organizing time so that unscheduled, same day services are routinely available to care team members.
• The ability to exercise sound judgment in appraising situations and making decisions regarding complex physical and behavioral health treatment issues in consultation with the primary care teams.
• Skill in developing effective working relationships with peers, supervisors, and professionals in related disciplines.
• Ability to manage complex personal interactions.
• Demonstrated ability to act with minimal supervision on personal initiative using sound clinical judgment.
• Strong written and verbal communication skills.

Preferred Qualifications

• Training in Integrated Behavioral Health
• Health care experience
• Experience and/or interest in Collaborative Care.
• Experience in a Primary Care Ambulatory Clinic setting.
• Experience with program development and evaluation.
• 3 years’ experience in similar position
• Language Knowledge: Spanish, Vietnamese, Mandarin, Cantonese, Russian, Arabic, Korean
• Licensed Clinical Social Worker (LCSW)
• Knowledge of the principles and practices of behavioral health consultation, including assessment, diagnosis, treatment planning, cognitive-behavioral counseling strategies and their application to population-based care for preventive and chronic care issues.
• Working knowledge of evidence-based psychosocial treatments and brief behavioral interventions for common mental health disorders, when appropriate (., motivational interviewing, problem-solving treatment, behavioral activation).
• Comprehensive understanding of the interrelationship between medical and psychological systems and their impact on health.
• Experience in documenting clinical activities in a comprehensive, clear, concise fashion on a same day basis. Basic knowledge of psychopharmacology for common mental health disorders

Additional Details

Hours: Variable. Five 8-hour shifts, Monday-Friday, with possibility of evening or weekend hours as needed for program needs.

The work is performed in a medical setting. The position involves interactions with people who have a wide variety of physical and behavioral health problems. Some travel may be required.

All are welcome

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or