AR Case Manager-SUD

Job Objective: The case manager is responsible for managing an assigned caseload of clients with substance use or other addiction-related illnesses.
The case manager is responsible for assessing needs, developing, implementing, reviewing treatment plans, and coordinating services for individuals and families served.
The case manager provides services and assists the treatment professionals in developing and delivering services to individuals challenged by addiction-related disorders.
Responsibilities and Essential Duties: • Accepts newly assigned cases in which the diagnostic intake has been completed by a licensed provider.
• Completes case management assessment on all patients entering caseload.
• Develops appropriate treatment/service plans with patients to implement appropriate services and develop effective alliances with patients.
• Provides ongoing support and/or case management functions according to the problems, needs, and strategies identified within the treatment plan to help the patient achieve the stated goals and objectives.
• Provides face-to-face reviews with patients and/or relevant staff on a regular basis, the progress made in achieving treatment goals so that the treatment plan can be modified as necessary to ensure that the goals and objectives have been achieved.
The treating provider and treatment plan will determine the frequency of reviews.
• Documents all contacts on a timely basis, including face-to-face interviews, meetings with treatment providers, maintains case records in accordance with regulatory standards and requirements.
• Assists the patients in obtaining appointments with external providers and facilitating patient use of community services.
o Refers patients to community resources as needed.
o Establishes and maintains relationships with identified service providers.
o Ensures that referrals are completed promptly.
• Maintains ongoing tracking and appropriate documentation on referral tracking.
o Communicates with the treatment team any issues or any need for further follow-up.
o Contacts the patient and/or family member regarding any pending referrals and/or diagnostic testing.
o Sends appropriate notifications, reminders, and letters to patients communicating referral status.
o Reviews details and expectations about the referral with patients.
o Ensures the patient's electronic health record is up to date with information on specialist consults, including documentation of scheduled appointments, results from specialists, and treatment recommendations.
• Meets regularly with immediate supervisor to enhance professional growth, review case management activities, and address administrative issues.
• Maintains close communication with the treatment team and support staff regarding medication compliance, side effects of medication, and medication changes and alerts these staff members to any changes in the patient which may suggest the need for intervention.
• Participates in regular interdisciplinary staff meetings held at position location.
• Other projects and duties as assigned.
• Supports the Mission, Values, and Vision of Community Care of West Virginia (CCWV) and the facility.
Patient Satisfaction: • Assist patients, family members, or other clients with concern and empathy.
• Respects client confidentiality and privacy and communicate with them in a courteous and respectful manner.
• Answers and refers telephone calls or other inquires to the appropriate team member to ensure accurate and timely communications are facilitated.
• Identifies self in a pleasant and positive manner.
• Takes responsibility for helping the patient.
Teamwork: • Assists in the orientation/training of new members of the care team.
• Consistently works in a positive and cooperative manner with fellow members of the care team.
• Assists others in the performance of their assignments.
• Seeks out opportunities to help rather than waiting to be asked.
• Considers the impact of their actions on peers throughout CCWV.
• Takes direction and initiates actions (cross/additional training) that will allow the assumption of cross-functional duties to ensure seamless patient care.
• Demonstrates flexibility to perform duties wherever volume deems it necessary within CCWV.
Problem Solving: • Demonstrates sound judgment by taking appropriate actions regarding questionable findings or concerns.
• Investigates and follows through on unusual orders or requests for service or information.
• Follows proper reporting procedures for actual or potential accidents and/or incidents so follow-up and/or prevention can occur.
• Consistently evaluate work and determine if further steps are needed to meet patient expectations.
• Ensures compliance with regulatory standards.
Productivity/ Efficiency: • Consistently demonstrates the ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
• Minimizes non-productive time and fills slow periods with activities that facilitate preparation for the department's future needs.
• Organizes job functions and work areas to facilitate effective completion of varied assignments within established time frames.
• Consistently demonstrates the ability to take the initiative in making decisions/choices without direct supervision.
Adherence to Departmental Policies: • Demonstrates knowledge and understanding of all policies and procedures and the ability to reference them from appropriate books and manuals.
• Complies with the CCWV's infection control policies and procedures, including the Bloodborne Pathogens Standard, to ensure a safe working environment for self and others.
Great Benefits Paid Time Off (PTO) Paid Holidays Extended Sick Pay (ESP) Medical Health Insurance and Prescription Coverage Basic Life Insurance for Employee and Family Short-Term Disability Long-Term Disability 401(k) Voluntary Contribution Plan Health Reimbursement Account Employee Elected Voluntary Coverage for Employee and Family Life Insurance, Dental, Vision, Flexible Spending Account, Dependent Spending Account Discounted undergraduate & graduate rates at West Virginia Wesleyan College for employee and family Physical Demands/Working Environment: • Work is performed in a professional medical office setting, business casual dress environment.
• Extended periods of sitting and/or standing, telephone, and computer work.
• Ability to see information in print and/or electronically.
• The job requires standing, walking, hearing, reaching, talking, and occasional lifting up to 25 pounds.
• Incumbents will be exposed to viruses, disease, and infection from patients and specimens in the working environment.
• The incumbent will be required to work at any facility and be responsible for their own transportation.
• Incumbents may experience traumatic situations, including psychiatric, dismembered, and deceased patients.
Qualifications/Requirements/Skills: • License & Certifications - None required.
• Working knowledge of the nature of serious mental illness and addiction and related treatment modalities.
• Knowledge of interventions and techniques and different types of assessments and their uses in treatment planning.
• Knowledge of clients' rights, local community resources, patient record documentation requirements, and patient treatment plan development and implementation.
• Demonstrated ability to interview and assess patients, using appropriate assessment tools, and observe, record, and report on an individual's functioning.
• Ability to read and understand assessments, evaluations, observations, and use in developing treatment plans.
• Ability to establish effective working relationships with staff and relevant community organizations and interact positively with patients and their families.
• Ability to work independently, as well as collaborate with multi-disciplinary teams and health care providers.
• Must demonstrate excellent interpersonal communication skills and the ability to engage with varying patient populations.
• Must be flexible and adaptable to change.
• Must have strong analytical, organizational, and time management skills.
• Must be able to work with little supervision while handling numerous projects at once.
• Must be able to effectively use electronic health records (EHR) to document patient interactions, progress, and other relevant information.
Education/Qualifications/Experience: • Possesses a combination of behavioral health work experience or relevant education and training, which indicates possession of knowledge, skills, and abilities to perform essential job duties.
• Bachelor's degree in social work, psychology, or human services-related field is preferred.
• Two (2) years of experience in a healthcare setting, preferably behavioral health or substance abuse.
• Experience working directly with individuals who have substance use disorders is highly preferred.
• Experience with Medicare and Medicaid population, insurance providers, and telephonic engagement.
• Experience in working with an underserved population preferred.