CLINICAL CARE MANAGER - STATE HOSPITAL (HYBRID)

Position Purpose The Clinical Care Manager- State Hospital Team provides person-centered, community-based clinical care management services for the clients in Community Transitions programs.

• The goal is to ensure that comprehensive, coordinated, easily accessible, culturally informed, trauma informed, and integrated services are available for people in the community;
• and to minimize the risk of readmissions to hospitals, emergency departments, withdrawal management, Colorado Crisis Services and arrest;

and to ensure an individual’s stability in the community. The Clinical Care Manager will provide supports to individuals with serious and persistent mental illness and substance use disorders, including going on-site at the Colorado State Hospitals prior to discharge, attending community behavioral health appointments to support client to engage in treatment, providing clinical input into discharge planning teams, and supporting the coordination of behavioral health treatment services.

The Clinical Care Manager- State Hospital Team is required to follow the Colorado Mental Health Hospital at Pueblo and the Colorado Mental Health Hospital at Fort Logan infectious disease and drug screening policies and procedures, including but not limited to compliance with COVID, Flu, Hepatitis-B, Tuberculosis vaccine, fingerprinting and urinalysis testing requirements.

Essential Duties Provide intensive care management for individuals to ensure a successful transition into community-based living and treatment from state hospitals, acute treatment centers, crisis services facilities, withdrawal management facilities, criminal justice settings, or other higher levels of care.

This includes meeting with individuals supported face to face in the community and in the hospital or through virtual means, at a frequency that meets minimum contractual requirements and is sufficient to provide the intensity of supports for successful community transition.

Ability to clinically assess an individual’s needs, including understanding mental health symptoms, coordinating behavioral health services and attending the first behavioral health appointment.

Ability to utilize clinical skills such as motivational interviewing and brief interventions. Complete health needs assessments and collaboratively develop person-centered individualized care plans that includes all activities and services that are essential to meet the specific needs of the client.

Monitors, evaluates, and updates the services listed in the care plan for their effectiveness in a timely manner. Assist in accessing services and coordinating care while ensuring individuals have all the resources required for daily living (such as : food, housing, therapies, and transportation).

Assist individuals and families in coordinating wraparound services and funding sources to secure needed behavioral health and physical health care needs.

This will include coordination with providers such as community mental health centers, primary care, case management, Assertive Community Treatment teams, Regional Accountable Entities, and others.

Advocate for the best interest of the individual by working with providers to resolve conflict as it relates to the individual’s care plan.

Collaborate with Peer Support Specialists to implement care plans, coordinate services, and communicate with treatment providers.

Educate Alternative Care Facility and Skilled Nursing Facility staff about successful interventions and care strategies for individuals, as needed to increase individual’s success in maintaining the least restrictive setting that can meet their needs.

Assist in linking with CMHC or other identified provider to enroll the client in the necessary and required behavioral health services.

Assist individuals to apply for appropriate housing vouchers when needed, and support them in locating, applying for, and attaining rental housing.

Assist with benefits acquisition where appropriate, including state and federal programs such as SSDI, SSI, Medicare and Medicaid.

Support individuals and families by securing needed services and goods that do not have another funding source. Track spending to a budget and obtain approval for spending that exceeds pre-approved limits.

Identify and report to supervisor any team activities and issues that influence the delivery of services under the contract.

Complete all documentation as required according to contractual, organizational, and legal requirements. Actively participate in supervision and case consultation.

Actively communicate with individuals, caregivers, families, stakeholders, advocates and providers. Ability to meet / work with staff, stakeholders or individuals in a variety of settings.

Attends staff, team and department meetings. Attends in-services, staffing and other meetings with supervisor’s approval.

May be appointed to committees. Participates in agency and community planning and education. Develops and maintains records, plans and reports.

Maintains prompt and regular attendance. Performs related work and other duties as assigned. Knowledge, Skills and Abilities Knowledge related to clinical diagnoses, including serious and persistent mental illness and substance use disorders, and ability to interact effectively with individuals experiencing these disorders.

Knowledge of general standards of practice in behavioral health settings and ability to communicate effectively with psychiatrists and other behavioral health clinicians.

Ability to work independently in the community and from a home office, and to travel to the RMHS office as required. Ability to work regular business hours as determined by the needs of the program.

Strong communication skills with individuals served in the program, team members, colleagues, and community partners. Ability to independently assess crisis situations and connect individuals to appropriate resources.

Knowledge of community resources related to the behavioral health needs of the individuals in the programs. Familiarity with DSM 5, behavioral health symptoms, and general medication side-effects.

Comfortable utilizing de-escalation strategies and Motivational Interviewing as needed Maintain strict confidentiality and fulfill requirements of HIPAA and other relevant rules and regulations.

Maintain appropriate boundaries and professional demeanor. Track client spending to a budget per program requirements. Document timely utilizing standards of practice for the profession.

Work independently with minimal supervision. Enter data timely and accurately per program requirements. Understand and use a person-centered, culturally informed and trauma informed principles.

Minimum Qualifications Bachelor’s Degree in Social Work or a related field, including specific training in behavioral health disorders.

3 years of experience providing direct services or intensive case management for individuals with serious and persistent mental illness and / or substance use disorders.

Preferred Qualifications 4 or more years of direct services AND intensive case management experience for individuals with serious and persistent mental illness and / or substance use disorders.

Master’s degree and license-eligible in social work, counseling, human services or related field. Bilingual Spanish speaking Employment Type : Full Time Years Experience : 3 - 5 years Salary : $50,000 - $60,000 Annual Bonus / Commission : No