Role and Responsibilities

The Case Manager is responsible for assisting individuals, eligible under the state plan, in gaining access to needed recovery supports, medical, social, educational, and other services. Case management duties include assessing the individualized needs of an individual, coordinating provision of services, and documenting services and outcomes. The Case Manager works in collaboration with the individual’s service team to facilitate access to services needed. The Case Manager will document all services, contacts and referrals made to patients.

POSITION RESPONSIBILITIES

General Duties:

• Attend meetings, seminars, and other educational functions as identified by supervisor.
• Participate actively in trainings, consultation and fidelity monitoring for evidence-based treatment models to enhance outcomes and service delivery.
• Maintain certification and licensure as required by the Agency and State Boards.
• Participate in case management supervision in accordance with 907 KAR 15:040 (Medicaid Regulation for Coverage Provisions and requirements regarding targeted case management for individuals with a substance abuse disorder).
• Dress professionally.
• Represent MCHC professionally in all interactions with patients, community partners and payor sources.
• Collaborate professionally with other treatment team members internal and external to MCHC.
• Maintain Confidentiality. All MCHC employees are privy to confidential patient information. Due to complex treatment needs of our patients, service providers have contacts that require written and verbal information exchange with different professionals and agencies. A strict code of behavior must be maintained to protect the special nature of divulged information.
• Follow all KY mandated reporting laws.
• Understand and maintain compliance with all applicable regulations (State and Federal), as well as applicable contractual obligations.
• Maintain Patient Rights as outlined in the MCHC Intake Packet.

Specific Duties

• Provides intake services including review of all intake paperwork and introduction to service delivery on behalf of MCHC.
• Administer standardized assessments during the intake process, if appropriate.
• Gather information on individual functioning for the purpose of integrating that information into comprehensive needs assessment.
• Complete Individual’s Case Management Needs Assessment with periodic review and reassessment of needs.
• Develop the individual’s plan of care that is driven from the needs assessment and individual input on their treatment needs.
• Complete periodic review of plan of care and revise in accordance with changing needs and completion of goals.
• Conduct face-to-face monitoring of individual’s receipt of care plan services every 90 days or more frequently as needed.
• Assist in making referrals for individual to gain access to needed recovery, medical, social, education and other service supports.
• Make contacts with non-recipients with the goal of helping the individual increase access to services; identify supports necessary for individual to be enabled to access services, and for information gathering relevant to the individual’s condition and treatment.
• Conduct face-to-face monthly contacts (as frequently as needed with a minimum of two to three times monthly dependent on status) with individuals receiving services, in order to accurately assess needs for case management services, to assist in evaluation of progress, and to identify and monitor the management of high-risk situations involving safety or possible relapse.
• Conduct telephone and face-to-face contacts (as frequently as needed with a minimum of two times monthly) with the individual and/or an agency on the behalf of the individual.
• Collaborate with other behavioral health professionals, physical health professionals and community partners to deliver integrated care.
• Maintain collaborative working relationships/communication with DCBS, courts and other agencies as requested by patient with the appropriate release of information.
• Request authorized services on a timely basis from the relevant MCO as required per MCO requirements.
• Adhere to all regulations and mandated reporting laws regarding any and all abuse and neglect allegations.
• Provide documentation of case management services to patients.
• Completes all required documentation (intake paperwork, case management needs assessment, progress notes, care plan, non-billable contacts, etc.) in accordance with all applicable regulations and company requirements.
• Document all services, contacts and referrals provided in the patient record.
• Document all referrals made to outside agencies and patient compliance with these referrals.
• Completes documentation with complete accuracy in accordance with agency documentation guidelines.
• Complete all needed Managed Care Organization, Insurance or Payer documentation needed to ensure approved service delivery or appeal decisions.
• Assists with special duties or responsibilities in the agency as assigned by Supervisor or Medical Director.

ESSENTIAL FUNCTIONS

• Analytical—the individual synthesizes complex or diverse information.
• Problem solving—the individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
• Oral communication—the individual speaks clearly and persuasively in positive or negative situations, demonstrates group presentation skills and conducts productive meetings
• Delegation—the individual delegates work assignments, gives authority to work independently, sets expectations and monitors delegated activities.
• Leadership—the individual inspires and motivates others to perform well and accepts feedback from others.
• Management skills—the individual includes staff in planning, decision-making, facilitating and process improvement; makes self-available to staff; provides regular performance feedback; and develops subordinates' skills and encourages growth.
• Quality management—the individual looks for ways to improve and promote quality and demonstrates accuracy and thoroughness.
• Judgment - the individual displays willingness to make decisions, exhibits sound and accurate judgment, and makes timely decisions.
• Planning/organizing—the individual prioritizes and plans work activities, uses time efficiently and develops realistic action plans.
• Safety and security—the individual observes safety and security procedures and uses equipment and materials properly.
• Dependability - Reports to work / meetings on time and completes assignments in timely manner. Follows call-in and approval procedures for time off.  Accepts responsibility when necessary to see that the job gets done.
• Initiative - Willingly assumes new or additional responsibilities. Routinely improves knowledge and skill level.  Works independently, when assigned.
• Planning and Organizational Skills - Adheres to priorities and deadlines; completes work within scheduled time frames. Utilizes available time effectively in performance of responsibilities.  Establishes and follows a course of action for self and/or others to accomplish tasks and responsibilities.
• Quantity and Quality of Work – Completes work with a high level of accuracy and a low level of errors. Produces neat, thorough and organized work.  Produces expected amount of work in accordance with length of time in position.  Assures fiscal viability of service delivery if applicable.
• Attitude – Demonstrates a cooperative, positive, and enthusiastic attitude towards fellow employees, patients, and visitors. Knows and follows confidentiality laws and procedures at all times.  Is effective in written and oral expression.  Demonstrates proper telephone etiquette and able to communicate easily.  Works independently, when assigned.  Conducts themselves in manner consistent with the agency’s code of ethics and code of conduct.
• Team Work/Collaboration - Direct, honest, tactful and respects the contribution of others. Assists others as needed including staff, patients, and visitors.  Interacts and cooperates with others to ensure the agency’s objectives and goals are met.  Demonstrates flexibility in responding to priorities and organizational change.  Accepts share of responsibilities when working with others to accomplish job requirements.

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

This position requires compliance with Health Center’s compliance standards, including its Standards of Conduct, Compliance Program, and policies and procedures. Such compliance will be an element considered as part of the regular performance evaluation.