Behavioral Health Care Manager and Counselor Reports to:
Care Management Supervisor FLSA Status:
Hourly Position Summary The Behavioral Health Care Manager and Counselor provides care management, care coordination, and direct behavioral health counseling for adult and/or adolescent patients with moderate to complex illness or behavioral health needs, in the primary care setting, under minimal supervision. This role delivers brief, evidence based counseling interventions directly to patients in addition to care management duties, and serves as the practice's frontline counseling resource within the integrated care team. Serves in an expanded health care role to collaborate with a multidisciplinary care management team, psychiatric consultant, and patients and families to ensure the delivery of quality, efficient, and cost effective health care services. Assesses care plans, implements, coordinates, monitors, and evaluates all options and services, including counseling interventions, with the goal of optimizing the patient's health and emotional status. Integrates evidence based clinical and counseling guidelines, preventive guidelines, and protocols, in the development of individualized care plans that are patient centric, promoting quality and efficiency in the delivery of health care. Counseling Duties (Core Function) Provides direct, individual counseling sessions to patients as part of the integrated care plan, addressing anxiety, depression, adjustment concerns, grief, and other behavioral health needs identified in primary care. Delivers brief, evidence based counseling interventions, including motivational interviewing, solution focused counseling, and cognitive behavioral techniques, to support behavioral change and coping. Conducts counseling based risk assessments (including suicide and self harm risk screening) and initiates appropriate safety planning and escalation with the PCP and psychiatric consultant. Builds and maintains a recurring counseling caseload, scheduling and documenting follow up sessions consistent with each patient's individualized plan of care. Coordinates counseling services with referrals to external behavioral health or psychiatric providers when a patient's needs exceed the scope of brief primary care based counseling. Maintains counseling documentation in accordance with professional, ethical, and licensure standards, and DayOne's HIPAA and confidentiality requirements. Care Management Duties Manages and actively follows a caseload of patients identified for behavioral health opportunities. Provides targeted interventions to avoid hospitalization and emergency room visits. Coordinates care across settings and helps patients and families understand health care options. Provides appropriate and timely intervention following PCP referral for a behavioral health need. Follows patient health, emotional status, and psychosocial needs of the patient and family using standard assessment tools. Collaborates with the PCP, patient, and members of the health care team, including the psychiatrist. Develops a comprehensive individualized plan of care and targeted interventions and continually monitors patient and family. Provides patient self management support with a focus on empowering the patient and family to build capacity for self care. Implements systems of care to facilitate close monitoring of high risk patients, including those with behavioral health needs. Implements clinical interventions and protocols based on evidence based clinical guidelines. Coordinates patient care through ongoing collaboration with the PCP, psychiatrist, patient and family, community, and other members of the health care team. Provides follow up with patient and family when the patient transitions from one setting to another in a timely manner. Demonstrates excellent written and verbal communication skills, positive relationship building skills, and critical analysis skills. Maintains required documentation for all care management activities. Ensures the program maintains compliance with HIPAA and related information security policies and ensures safekeeping of confidential information. Education and Experience Master of Social Work license (LCSW or LMSW) Demonstrated training or supervised experience in direct patient counseling (individual counseling, motivational interviewing, CBT informed techniques, or solution focused counseling). Behavioral health specialized training or experience in behavioral health within the past 5 years. Knowledge of chronic conditions, evidence based guidelines, prevention, wellness, risk assessment, and patient education. Critical thinking skills and the ability to manage complex clinical and counseling issues utilizing assessment skills and protocols. Excellent assessment and triage skills, with the ability to implement evidence based counseling and care interventions. Excellent verbal and written communication skills, including strong organizational, detail, and interpersonal skills. Ability to initiate and maintain positive working relationships with staff and other organizations. Efficiently manages time with minimal supervision. Ability and willingness to provide patient education, counseling, support, and motivation to patients regarding their care. Care management, counseling, and patient self management training. Computer skills and knowledge of word processing. Current Michigan license. Team player. Able to engage patients, family, caregivers, other members of the care management team, and the client practice PCMH team in a common understanding of each patient's individual plan for health. Time management, organizational, and prioritization skills. Sensitive to cultural, linguistic, and psychosocial barriers to successful self management, counseling engagement, and implementation of the individual care management plan. Creates a sense of empowerment on the part of patients, family, and caregivers. Manages multiple and conflicting priorities. Able to resolve customer inquiries and complaints in a timely manner, consistent with corporate policy. Extroverted personality that enjoys interacting with new people from different backgrounds. Use of technology such as EMR. Physical Requirements Prolonged periods of sitting at a desk, in counseling sessions, and working on a computer. Must be able to lift up to 15 pounds at times. Benefit Conditions Waiting period may apply.
Culture Outcome oriented:
results focused with a strong performance culture.
People oriented:
supportive and fairness focused.
Team oriented:
cooperative and collaborative. This Job Is Ideal for
Someone Who Is Dependable:
more reliable than spontaneous.
People oriented:
enjoys interacting with people, counseling patients, and working on group projects.
Job Type:
Full-time Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Flexible schedule Health insurance Life insurance Paid time off Retirement plan Vision insurance
