Care Manager

QUALIFICATIONS:

Bachelors degree in health related field of counseling, psychology, social work, sociology, behavioral science field or must be licensed nurse. LPNs must have fifteen (15) semester hours of behavioral health and one (1) year of behavioral health care experience. Alternate Bachelors degree must have fifteen (15) college level semester hours of coursework in behavioral health or at least one (1) year of work experience in a behavioral health setting.

POSITION SUMMARY:

Providing support to individuals in need of accessing community resources, building natural supports within the community, and coordinating care between all health care providers. The Care Manager will also determine potential strengths and ways to empower the individual to overcome daily mental health symptomology. The Care Manager will work with the Care Team to develop an individualized Person-Centered Care Plan that addressed all the deficiencies of the individual receiving care.

The person holding this position is expected to attend In-Service(s) and all other trainings as required. They will be expected to complete any and all documentation work as a team member in a timely manner.

The person holding this position is delegated the responsibility for carrying out the assigned duties and responsibilities in accordance with current existing federal and state regulations and established company policies and procedures.

PRIMARY JOB DUTIES AND RESPONSIBILITIES:

• Care Management program will provide services that are consistent with members rights including, but not limited to members choice and confidentiality as stipulated by state and federal statute.
• Care Management programs encourage the involvement of members, family member/caregivers and significant others in the community resource development and linkages. In addition, the linkages with mentoring programs provided by members and family members should be a priority.
• Referral & Coordination Descriptions policies and procedures regarding referral and coordination mechanism (including responsibility for transportation when required) for services outside the program, include but are not limited to:

• Psychiatric rehabilitation programs
• Employment resources
• Providers of transportation services
• Housing developers/coordinators
• Law enforcement
• Primary Care Provider (PCP)
• Bureau of TennCare
• Providers of housing services
• Social Security Administration
• Managed Care Company (MCC)
• Behavioral Health Organizations (BHO)
• Medical hospital & emergency rooms
• Inpatient psychiatric hospitals
• Outpatient mental health providers
• Alcohol & drug treatment providers
• Social services agencies
• Adult protective services
• Providers of educational services
• Court system
• Juvenile justice system agencies
• Department of Childrens Services
• Mobile Crisis Response Teams
• Mentoring programs provided by members and family members
• A Comprehensive Care Plan (CCP) will be developed for each member within (24hrs) days of enrollment in (THL) Tennessee Health Link. It will be based upon the needs identified in the initial assessment as well as in the individuals CANS/ANSA assessment. The Comprehensive Care Plan will be reviewed every (90) days. Documentation in the service plan must include the follow:

• Member name, MCC identification number, and DOB
• Date of Plan development
• Documentation of each life functioning domain(s) based upon prioritized needs and desires, as identified in the member assessment. Each domain in which the member is working must contain the following documentation:

• Measurable long terms goals
• Measureable Objectives and Interventions.
• DSM-5 DX.
• Anticipated Target Date.
• Documentation of participants in individuals plan.
• Crisis Plan must be developed within twenty-four (24) hours of enrollment into Mental Health Care Management. This plan is to include the following elements:

• Members name and locator information
• Diagnosis & medical information
• Plans for and step in crisis resolution process
• Signs & symptoms of decomposition including predisposing factors
• Crisis interventions to be avoided.

• CM will document that it encourages member and family member/caregiver involvement.
• CM will document that it ensures access to Care Management for members with mental health and substance use diagnosis.
• CM will provide evidence that it has performance monitoring standards and tracks and monitors outcome date for member receiving CM services.
• CM will demonstrate cultural competence in the administration, design and deliver of CM services are clinically appropriate
• CM will obtain and maintain an F endorsement on their drivers license to assist in transportation services as required.
• CM will provide documentations of at least 1 monthly contact with the service recipient.
• CM will provide evidence that medical records for each member will contain the following at minimum;

• Assessments completed prior to the development of the MHCM Comprehensive Care Plan.
• A MHCM Care Plan developed within thirty (24) hours of enrollment into MHCH, containing the elements described herein.
• A MHCM Crisis Plan developed within twenty-four (24) hours of enrollment into MHCM containing the elements described herein.
• Progress notes after each service contact.
• Current Authorization to Release Forms for members PCP, Pharmacy, Emergency Contact, Past Providers, and other current Providers.
• A current Preliminary Discharge Plan updated monthly for ARTF, Quarterly for Enhanced, and every six month for Supportive levels of care and Community Based Outpatients.
• CANS/ANSA assessment and follow-up.

PHYSICAL REQUIREMENTS:

Literate, emotional maturity, poise, visual and hearing acuity and dignity.

WORKING AREA AND ENVIRONMENT:

SPECIAL DEMANDS:

Applicant needs to be able to work effectively with individuals that have deficiencies in personal interaction and have delay in being able to effectively cope with his or her daily emotions. Therefore, applicant needs to exhibit in patience in all settings with specific emphasis on listening and expressing genuine care and concern for the population.

DISCLAIMER:

The above job description has been written to indicate the general nature and level of work performed by employees within this classification. It is not written to be inclusive of all duties, responsibilities and qualifications required of employees assigned to this job.