Community Based Care Manager

2 weeks ago


Philadelphia, United States PHMC Full time

PHMC is proud to be a leader in public health. PHMC requires that all employees are fully vaccinated with the Covid-19 vaccine before the first day of employment.

Community-Based Care Manager (CBCM) sought to work as part of the opioid Use Disorder (OUD) Medical Home, also referred to as Center of Excellence (COE). This COE has been created by the Commonwealth of Pennsylvania to help address systematic factors that contribute to problematic use of opioids in the community. Duties will include working with a care management team to accept referrals of individuals with OUD from local emergency departments, state and county corrections facilities, inpatient and outpatient residential substance use providers, and from primary care providers and helping these individuals connect to, and remain supported by, a variety of community resources.

The CBCM will work to motivate and encourage individuals with OUD to stay engaged in both physical health and mental health treatment. The CBCM will be responsible for connecting with new individuals with OUD via outreach to address their care needs, as well as ensure continued engagement of referred individuals with OUD to assist with ongoing care coordination. The CBCM reports directly to the LCSW supervisor. This is a full-time position that will require frequent, local travel.

*Responsibilities:

  • Outreach within target communities and key institutions including, prisons, hospitals, primary care settings, and homeless shelters, to reach adults struggling with opioid use disorder, and connect then to assessments with the COE
  • Providing ongoing support to assigned individuals with OUD and additional needs, to help them access resources that will assist in improving their treatment and daily life This includes monitoring at a regular, assigned frequency to assess resource connection and helpfulness, and troubleshooting problems that arise.
  • Consultation with primary care and treatment providers to ensure patients struggling with OUD are fully engaged in care, provide support for treatment planning, and assist in the implementation of evidence -based assessments and care connection
  • Productively work to help the COE meet program expectations tor outreach and care
  • Participate in a learning network that will include increasing awareness of OUD-related resources and needs; complex case-based learning; and ongoing supervision will occur with the COE
  • Partner with Quality Management, LSW, and clinical teams to track and internally report key metrics at an individual and aggregate
  • Maintain appropriate records of activities, patients, fidelity, and outcomes
Coordination of Care:
  • Facilitate recovery by helping individuals find stable housing and employment and help them to re-establish family/community relationships. Provide feedback to and coordinate care of patients with health center primary care staff. Identify, refer, and advocate for patients needing specialty behavioral health service, and other services as needed.
*Skills:
  • Excellent interpersonal skills; comfort working with diverse populations
  • and in multidisciplinary teams;
  • Ability to maintain client confidentiality; sensitivity to racial/ethnic and economic diversity;
  • Microsoft Office and basic computing skills; ability to complete computer-generated
*Experience:
  • Experience working as a member of an interdisciplinary team
  • Comfort working with diverse populations (i.e. race, ethnicity, diagnoses, age ranges)
  • Preference is placed on prospective employees who have demonstrated experience in community outreach, working with vulnerable populations (including but not limited to incarcerated individuals, those with substance use and/or mental health conditions), and/or community advocacy in North Philadelphia
*Education Requirement:
  • Bachelors’ Degree in Social Work or related field from an accredited school, or Associates Degree in human Services or related field from an accredited school plus minimum three years of related work experience, or equivalent experience.
Salary: Based on education and experience.

FLSA Classification: Non-Exempt
  • This position is classified as salaried non-exempt in accordance to FLSA standards.


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