Behavior Health

Coordinates Team-based care to provide health services to individuals, through effective partnerships with
patients, their caregivers/families, community resources and their physician. Facilitates a "shared goal
model" within and across settings to achieve coordinated high-quality care that is patient and family
centered.
Continued employment and raises in this position are dependent upon Central Montana Medical Center's
fiscal viability and: •
Actions and communications that contribute to a team concept and create a
positive environment for all customers •
Acceptable performance of essential and all job duties •
Acceptable attendance record •
Accountability for safety to self, patients, visitors and all customers, and care of
equipment and building •
Adherence to departmental and facility policies and procedures, education
requirements, compliance monitoring and reporting, and CMMC Code of
Conduct •
Accountability for the consequences of own actions •
Physical and emotional ability to perform essential functions •
Acceptable background investigation results if required for position
Minimum Education, Experience, Licensure, Certification required:
Current RN license required;
Psychiatric-Mental Health Nursing Certification preferred;
3-5 years of experience in clinical or community health settings is preferred;
Previous Care Coordination, Case Management or Behavioral Health experience preferred;
Previous experience with mobilizing community resources, navigating patients through the healthcare
continuum and working with diverse populations
ESSENTIAL FUNCTIONS/DUTIES:
(Must be able to perform with or without accommodation)
1 Provide a coordinated, strategic approach effectively manage the behavioral health patient population.
2 Implement an effective internal tracking system for identified patients.
3 Serve as main point of contact for behavioral health department and facilitate warm hand-offs from

primary care.
4 Assist in triaging new patient referrals and work with scheduling team to ensure timely access to

behavioral health services.
5 Assess patient and family's unmet health and social needs and assist in navigating community

resources.
6 Help develop a care plan based on mutual goals with the patient, family and provider.

7 Monitor patient adherence to plan of care and progress toward goals in a timely fashion and facilitate
changes as needed.

8 Create ongoing processes for patients/families to determine and request the level of care coordination
support they desire over time.

9 Utilize tools and documents that support a guided care process, collaborate with patient/family toward
an effective plan of care.

Coordinator RN

10 Facilitate patient access to appropriate medical and behavioral health and other relevant specialty

providers.
11 Cultivate and support primary care and behavioral health co-management with timely communication

inquiry, follow-up and integration of information into the care plan regarding transitions-in-care and
referrals.

12 Serve as the contact-point, advocate and informational resource for behavioral health needs
13 Ensure effective tracking of medication management and adherence to follow-up appointments.
14 Provides accurate and representative written documentation on patient medical records. Maintains all

required reports, records, statistics, quality assurance and continuous quality improvement data.
15 Prepares patients for scheduled appointments and assists providers in patient assessment &

procedures as needed.
16 Attend and actively participate in all Care Coordination related training and meeting activities.
17 Other duties as assigned.

Knowledge, Skills, Abilities:
Ability to communicate and effectively work with hospital personnel and medical staff
Ability to adapt to fluctuations in workload and work efficiently and effectively under stressful conditions.
Willingness to assume additional duties when requested and seek guidance and direction, when needed, for
performance of duties and ability to recognize, establish and respond to priorities.
OCCUPATIONAL EPOSURE for this position:

Category I Direct contact with blood or other bodily fluid to which
universal precautions apply

Category II Activity performed without blood/bodily fluids exposure, but
exposure may occur in emergency

Category III Task/activity does not ordinarily entail predictable exposure to
blood/bodily fluids

OTHER EPOSURE for this position: Radiation Noise Other (Specify)

PHYSICAL DEMANDS:
(Essential functions strength rating for position - see Job Analysis)
Sedentary Exert up to 10# occasionally or negligible force frequently
Light Exert up to 20# occasionally, < 10# frequently or negligible

force constantly Medium Exert up to 50# occasionally, up to 25# or up to 10# constantly

Heavy Exert up to 100# occasionally, up to 50# frequently or up to
20# constantly

Very Heavy Exert > 100# occasionally, > 50# frequently or
> 20# constantly