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Care Coordinator, Children's Outpatient
3 months ago
Overview
Certified Community Behavioral Health Clinics (CCBHC’s) seek to improve the behavioral health of their communities by: providing outpatient mental and substance use disorder services; advancing integration of behavioral health with physical health care; assimilating and utilizing evidence-based practices on a more consistent basis; and promoting improved access to high quality care.
Responsibilities
General Responsibilities:
Assess and re-evaluate patient needs utilizing information from EHR and additional tools as appropriate to determine patient needs and preferences and communicate those to all treatment participants Create an Integrated Care Plan in conjunction with the patient and/or caregiver Ensure the patient understands the Care Plan and is equipped to follow it Identify and address all barriers that might impede the ability of the patient to care for themselves Assemble appropriate team of professionals to assist in meeting patient needs, organize patient care activities and share information among all participants Assist the patient/caretaker in navigating the health system while addressing any insurance coverage issues Update assessment and care plan at least every 90 days Utilize the Integrated Care Plan to drive all activities and services Provide information and feedback in daily Huddles regarding needs, plans/interventions/results Research ways to meet needs and put action steps in place, monitor for progress Advocate on behalf of the patient Follow up regularly with patient to ensure needs are being met and identify any changes to patient circumstances, any compliance concerns Consult with treatment team when noncompliance is found Provide training on disease management and healthy living skills Provides initial Diabetes Care Introduction Provide support and education for patient and their support system Facilitate securing/providing medical records when patient is in the hospital, ED, etc. Track and support patients when they obtain services outside the practice. Follow-up with patients within a few days of an emergency room visit or hospital discharge. Communicate test results and care plans to patients/families. Collaborate and consult with staff members and outside sources in the delivery and arrangement of services Demonstrates the ability to recognize the elements of a crisis state and knows how to deescalate or resolve the situation Effectively demonstrates the application of adult specific competenciesSupervision and Consultation:
Seek supervision and consultation as needed Accept and employs suggestions for improvement Actively works to enhance skillsClinical Record Keeping:
Document in a timely fashion per AltaPointe policy Document in a clear and concise manner. Document legiblyCourteous and respectful attitudes towards consumers, visitors, and co-workers:
Treat patients with care, dignity, and respect Respect privacy and confidentiality Assist others as needed Adopt a teamwork approach with coworkersAdministrative and Other Related Duties as Assigned:
Actively participates in Performance Improvement activities Actively participates in AltaPointe committees as required Completes assigned tasks in a timely manner Follows AltaPointe policies and procedures Attends appropriate in-services training and other workshops
Qualifications
Bachelor’s degree in a behavioral health or social services related discipline, Registered nurse, or Licensed Practical Nurse. Must meet all driving requirements.
Knowledge in adult specialties, outlined below, to be attained within six (6) months of employment:
Psychiatric disorders in adult populations Chronic medical conditions Trauma Informed Care Cultural diversity Social determinants of health How to administer and utilize basic assessment tools to assess needs and create an Integrated Care Plan Resources available to meet the needs of patients based on payor source Utilizing electronic health records Behavior management, crisis intervention and interventions common to acute psychotic consumers, as well as, to non-violent crisis intervention practices.
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