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Disease Management Outreach Worker

4 months ago

Kennett, United States FCC Behavioral Health Full time
Job DescriptionJob Description

Job Purpose

The Outreach Coordinator (OC) is responsible for conducting outreach visits and phone calls with clients who are listed in the cohort distributed to FCC by the Department of Behavioral Health. The OC assists with promoting wellness and a healthy lifestyle while working with clients on the goals they want to achieve in life.

Qualifications

  • Bachelor’s degree in social work, psychology, or related field OR
  • Any combination of education, training, and experience equivalent to possession of a bachelor's degree that demonstrates the ability to perform the duties and responsibilities.

Core Job Duties

  • Outreach clients on provided cohorts by visit, phone, and letter.
  • Utilize resources to locate clients (EMOMED, Cyberaccess, CareManager, etc).
  • Assist with enrolling the client in appropriate FCC services.
  • Assist with locating community resources for the clients as needed.
  • Assist/monitor enrolled clients for DM housing funds, HCH enrollment, and metabolic screenings.
  • Assist in the process of transferring a client who has moved outside of the service area to another agency in order to ensure they have the opportunity to enroll in services.
  • Assist individuals in crisis including locating and coordinating resources to resolve a crisis.
  • Ensuring communication and coordination with and between multiple service providers.
  • Demonstrate an understanding of the importance of Medication compliance with the clients.
  • Helping individuals develop skills and resources that foster success.
  • Complete status updates in CareManager as required by DMH.
  • Monitor and complete discharge follow up calls.
  • Adherence to all applicable evidence-based practice models.
  • Demonstrate a working knowledge of diagnostic criteria sets for substance use and/or mental disorders.
  • Orally communicate information effectively and accurately.
  • Assure program operates within the constraints of the agency’s certification (CARF, DMH) standards and strategic plan related to clinical care.
  • Abide by program and agency policies and procedures.
  • Other job duties and special projects as assigned.