Behavioral Health Care Manager - LSW, LMHC, LMFT, LMSW

Roles and Responsibilities:

• Screen and assess patients for common mental health and substance abuse disorders, assigning the patient to a caseload/registry when appropriate per program parameters.
• Support the mental and physical health care of patients on an assigned patient caseload. Closely coordinate care with the patient's medical provider and, when appropriate, other mental health providers.
• Facilitate patient engagement and follow-up care using a treatment-to-target framework.
• Provide patient education about common mental health and substance abuse disorders and the available treatment options.
• Systematically track treatment response and monitor patients (in person or by telephone) for changes in clinical symptoms and treatment side effects or complications.
• Support psychotropic medication management as prescribed by medical providers, focusing on monitoring treatment adherence, side effects, and effectiveness of treatment. When necessary, facilitate PCP linkage with the psychiatric consultant.
• Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate.
• Provide or facilitate in-clinic or outside referrals to evidence-based psychosocial treatments (e.g. problem-solving treatment or behavioral activation) as clinically indicated.
• Participate in regularly scheduled (usually weekly) caseload consultation with the psychiatric consultant and communicate resulting treatment recommendations to the patient's medical provider. Consultations will focus on patients new to the caseload and those who are not improving as expected under the current treatment plan. Case reviews may be conducted by telephone, video, or in person.
• Track patient follow up and clinical outcomes using a HIPAA-compliant registry. Document all patient encounters in the registry and use the system to identify and re-engage patients.
• Document patient progress and treatment recommendations in EHR and other required systems to be shared with medical providers, psychiatric consultant, and other treating providers.
• 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.
• Facilitate referrals for clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).

EDUCATION/EXPERIENCE

• Training in one of the following fields (licensure preferred but not required):
  • Clinical or Medical Social Work, to include LCSW or LMSW
  • Mental Health Counseling, to include LMHC
• Flexibility to adapt to high-paced medical environments as a member of a dynamic care team.
• Demonstrated ability to collaborate and communicate effectively in a team setting.
• Ability to establish and maintain effective and professional relationships with patients and other members of the care team.
• Working knowledge of differential diagnosis of common mental health and/or substance abuse disorders, when appropriate.
• Experience working with a pediatric population is strongly preferred.
• Experience with assessment and treatment planning for common mental health and/or substance use disorders.
• Working knowledge of evidence-based psychosocial treatments and brief behavioral interventions for common mental health disorders, when appropriate (e.g., motivational interviewing, problem-solving treatment, behavioral activation).
• Basic knowledge of psychopharmacology for common mental health disorders that is within appropriate scope of primary care.
• Ability to effectively engage patients in a therapeutic relationship, when appropriate.
• Proficiency with technology, including video conferencing platforms.
• Familiarity with using electronic medical record systems.
• Training and / or experience in integrated behavioral health care (especially PCBH and CoCM) preferred but not required.

The Behavioral Health Care Manager (BHCM) is a member of a fast-paced, innovative Integrated Behavioral Health team, which uses blended Primary Care Behavioral Health (PCBH) and Collaborative Care (CoCM) integrated care principles to expand behavioral health care coverage across Universal Primary Care's patient populations. They work closely with other behavioral health professionals as well as primary care teams to provide carefully coordinated shared-care of patients presenting with mental health concerns common to a general medical patient population. The BHCM works closely in concert with patients' medical providers, a psychiatric consultant, and the larger primary care team using standardized tools and evidence-based practices to help meet defined patient care goals. The BHCM collaborates with the primary care team to offer brief assessment, management, and referral services for patients with behavioral health needs. The BHCM will be responsible for supporting and coordinating the mental and physical health care of patients with defined mental health conditions (i.e., anxiety and depression) on an assigned patient caseload via a "Collaborative Care" model of care delivery.