Behavioral Health Care Coordinator

SUMMARY:

The Behavioral Health Care Coordinator serves as an active member of the Care Navigation Team structure at SHHC supporting the providers by providing quality comprehensive services to patients and working collaboratively with staff to provide team-based coordinated care. The Behavioral Health Care Coordinator is responsible for supporting and coordinating the mental and physical health care of patients on an assigned patient caseload with the patient’s medical provider and, when appropriate, other mental health providers.The Behavioral Health Care Coordinator will demonstrate the values consistent with Squirrel Hill Health Center’s mission and will work with the SHHC team to make the Center a Medical Home for patients of all backgrounds.

RESPONSIBILITIES

1. Process team referrals and follow up on urgent referrals.  Obtains proper release of information documentation as needed.
2. Prepare forms (Service Coordination, Mobile Mental Health Therapy, child and adult therapy referrals, other letters and referrals as needed for provider signature. Mail or fax forms and information (referrals, letters, etc.) as needed for patients or providers.
3. Participates in the Behavioral Health team huddle.
4. Support the mental and physical health care of patients on an assigned patient caseload.
5. Closely coordinate care with the patient’s medical provider and, when appropriate, other mental health providers.
6. Screen and assess patients for common mental health and substance abuse disorders.
7. Facilitate patient engagement and follow-up care.
8. Provide patient education about common mental health and substance abuse disorders and the available treatment options.
9. Systematically track treatment response and monitor patients (in person or by telephone) for changes in clinical symptoms and treatment side effects or complications.
10. Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
11.  Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate.
12. Track patient follow up and clinical outcomes using a registry. Document in-person and telephone encounters in the registry and use the system to identify and re-engage patients.
13. Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant regarding who may need more intensive or more specialized mental health care
14. Call patients in advance of visit with patient-specific reminders if necessary.
15. Assist patients in obtaining appointments for referrals when complex or when patients face barriers.
16. Assist patients with access to internal or external resources, and ongoing follow up to resolve issues and/or referral to appropriate level of care. 
17. Identify barriers for patients and help remove barriers to care.
18. Maintain confidentiality and compliance with HIPAA;
19. Adhere to all SHHC policies and procedures;
20. Accurately, promptly, and consistently documents all patient interactions in Electronic Health Record.

CORE COMPETENCY:

1. Basic understanding of health care system and behavioral health diagnosis.
2. Attention to detail, ability to multi-task, work effectively as a team member
3. Excellent interpersonal and communications skills.
4. Able to communicate effectively with a wide range of clients in person and by telephone.
5. Responds to patient, clinician, and other requests in a courteous, respectful manner.
6. Able to follow logical and timely approaches to solving problems and making decisions regarding managed care.
7. Ability to structure time systematically, to manage work efficiently and consistently.
8. Ability to establish and maintain effective working relationships with staff, patients and the public.
9. Ability to work independently with minimal supervision.
10. If fluent in a second language is able to speak and understand that language in person and on the phone.

QUALIFICATIONS:

1. Social service experience and case management experience preferred.
2. 3-5 years of behavioral health experience or BS preferred.
3. Excellent organizational skills and ability to deal effectively with the public.
4. Skill in Microsoft Office Suite; Electronic Health Record and related systems.
5. Knowledge of a second language preferred.
6. Must be committed to serving populations consistent with SHHC’s mission.
7. Ability an willingness to receive all immunizations required by SHHC.
8. Ability to work in any SHHC location as needed.

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