Job Title: Case Manager for Circle of Friends

Department: Community Programs

FLSA Status: Non-Exempt

Reports To: Wellness Program Manager

Hours: Monday through Friday 8:30am to 5:00pm

Location: Burney

PROGRAM DESCRIPTION:

Hill Country Community Clinic has been awarded a SAMHSA grant to become a Certified Community Behavioral Health Clinic (CCBHC). This enables Hill Country to expand and refine our recovery-oriented approach to substance use and mental health services, especially for people with very complex needs. CCBHC’s are designed to provide whole person care with a comprehensive range of mental health and substance use services to vulnerable adults and children. Whole Person Care means all aspects of a person’s health is considered, including their physical, mental and behavioral health, socio-economic status, housing and other psychosocial needs that can impact their health. CCBHC’s are presently considered the “gold standard” care model for people with complex needs.

In practice, the CCBHC team partners with primary care and other programs to screen and engage with people, including identification of social factors that may be contributing to health concerns or risks. Treatment plan goals will be developed, together with the participant and their family members, with special attention to participants’ goals, needs and risks.

Under minimal supervision, work independently and together with Circle of Friends and Hill Country Community Clinic teams to provide outreach and direct case management services to help clients achieve wellness and recovery goals. The Case Manager is responsible for managing an assigned caseload. Individuals have diverse, complex health care needs that require comprehensive case management services, including SUD, mental health disorders, chronic health conditions and behavioral issues. This is a versatile position that may require field work and collaborative efforts within the community.

The CCBHC Case Manager will provide engagement and support services, particularly to program participants engaging in behaviors that pose health and safety risks by: making meeting individuals “where they are” and providing non-judgmental, non-coercive services, and resources to meet their needs.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned which may become essential to the position.

• Provide outreach and direct case management services in a professional and culturally competent manner to persons/families.
• Initiate contact and establish positive rapport with clients/potential clients.
• Provide clients with empathy, encouragement, support, and facilitate problem solving.
• Interview clients to identify areas of need, strengths, resources, and goals.
• Help clients make use of their own strengths and resources in addressing their needs/goals
• Conduct mental status exams, provide crisis intervention, and coordinate emergency care as needed.
• Assist clients in obtaining basic needs (i.e. food, clothing, shelter).
• Advocate for clients as needed to obtain housing, public benefits, and other community resources.
• Help clients develop budgeting and money management skills.
• Coach clients regarding activities of daily living, social skills, and communication skills.
• Making referrals to community resources to best meet their needs and follow up as needed.
• Assist clients in finding and using opportunities and resources to improve quality of life (e.g. education, employment, volunteering, recreation, etc.).
• Work creatively with other team members to implement a “whatever it takes” approach to support resilience, wellness and recovery among clients. This includes participation in team meetings, daily communications with team members, collaborative problem solving and advocacy.
• Complete documentation of interactions, assessments, interventions, and services provided on a daily basis.
• Complete data collection for tracking and reporting of the CCBHC grant activities, including NOMS data at intake, six-month follow-up and discharge.
• Build collaborative relationships with HCHWC staff, social service providers, schools, employers, emergency service personnel, and other community agencies and individuals.
• Improve quality of services provided at Hill Country Community Clinic by developing and sharing knowledge and expertise about community resources, public benefits programs, work/volunteer opportunities, etc., with other staff.
• Increase professional competence by participating in available training opportunities.
• Attend weekly team meetings, and other meetings as appropriate.
• Other projects and tasks assigned

SUPERVISORY RESPONSIBILITIES:

This job has no direct supervisory responsibilities, however, is responsible for collaboration with CCBHC and Circle of Friends staff, as well as the larger HCCC staff as needed to serve our clients and community.

BEHAVIORAL STANDARDS:

• Adheres to Policies & Procedures
• Participating in team systems
• Perform duties ethically
• Maintains client confidentiality
• Demonstrates ability to re-prioritize duties as the need arises
• Use time efficiently
• Be responsible for co-workers & client satisfaction
• Displays flexibility in accepting, changing or carrying out assignments
• Maintains a neat, clean & safe work environment throughout the facility
• Performs job duties in a quality manner

QUALIFICATIONS:

The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education/

Experience:

Must have B.S. degree in social work or related study, or the equivalent in related work experience.

Certificates and Licenses:

CPR certificate preferred. Must have a current and clean CA driver’s license required.

Language Ability:

Must have excellent communication skills. Ability to speak publicly and one-on-one in an effective and persuasive manner. Ability to read, write, analyze, and interpret complex documents. Ability to respond effectively to the most sensitive inquiries or complaints.

Math Ability:

Must have intermediate math skills, sufficient enough to help clients develop budgets and manage personal finances. This includes basic abilities to add, subtract, multiply, and divide.

Reasoning Ability:

Must have very high reasoning skills. Ability to assess mental status and determine needs for emergency interventions or other forms of care. Ability to define problems, collect information, establish facts, and draw valid conclusions.

Computer Skills:

To perform this job successfully, an individual should have good working knowledge of Windows operating systems, Microsoft Office Suite - Word, Excel, Outlook, and Internet browsers and related software.

Equipment Skills:

Proficient with standard office equipment including computers, copiers, fax machines, printers, multi-line telephone systems. Must be an experienced driver and comfortable driving with passengers.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

The work environment is an indoor business office environment and health clinic, a vehicle for transporting clients, other agency office settings, schools, and the homes of patients. The noise level in the work environment is usually moderate with normal business office, computer and printer noise.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee will frequently stand, walk, sit, use hands to write, and reach with hands and arms. Employees may occasionally climb or balance, stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds with assistance. Employees must regularly utilize close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.