Clinical Case Manager (30196)

Description

Purpose: (General description and summary)

The Clinical Case Manager (CCM) provides community-based interventions designed to stabilize and support high-need individuals living at the Clifford Apartments with an assertive engagement approach. Clifford is a unique program that provides low-barrier clinical and supportive housing services through several sub-programs. New Narrative partners with Innovative Housing Inc, the building owner, to provide supportive housing services for up to 35 of their 88 units, and limited case management and coordination for other residents. Outpatient clinical mental health services are available to any resident who has a qualifying mental health diagnosis.

Diagnosis scope will require skills in working with folks with high acuity, those experiencing houselessness, frequent hospitalizations, substance use disorders, and/ or incidents of heighten emotions or psychiatric status. This role requires extensive care coordination, risk assessment, and crisis de-escalation skills. This position will spend time providing treatment in community and clinical settings, including dedicated time on site at Clifford meeting 1:1 and in groups with participants, time at clinic for administrative tasks, as well as expectation for mobilization to Clifford as clinically indicated.

Environment:

This is primarily community based outreach position where 60-75% of your time will be in the community in a mixture of direct care, coordination, skills training, transportation, or travel. You will be provided technology to support community based work. Due to the nature of the work, you will be exposed to various weather conditions and living environments, and expected to maintain outreaching unless directed to otherwise by your supervisor. There is an office space at a clinic for administrative tasks and team meetings. This is direct care role that requires in person contact with participants, including meeting in their homes (units), in the community, and/or in clinic.

Accountabilities: (Responsibilities of the job)

The Clinical Case Manager works in tandem with QMHP Mental Health Clinician to create and implement the participant’s individual service plan. The clinical team will provide interdisciplinary care and wrap around services to support participants in obtaining access to resources, meeting basic needs, accomplishing goals outlined in their service plan, and attaining the highest level of independence possible.

Case Management

• Assist participants in connecting to resources needed to achieve goals set in individual service and support plan
• Develop relationships with providers and stakeholders to facilitate service provision
• Have regular, frequent contact with participants in the community (ie. units, Clifford, etc.)
• Medication Management/assist with prescriber visits
• Provide money management counseling intervening, if necessary, with landlords and other community stakeholders to ensure residential stability and fiscal responsibility of participants
• Provide transportation as needed to/from appointments to ensure connection and access to resources, as well as skills training opportunities in the community, etc.
  
  

Skills Training

• Collaborate closely with Mental Health Clinicians to incorporate appropriate interventions into each participant’s service plan.
• Assist participant’s with skills training related to individual ADL, iADL, and other goals identified in the individual service and support plan.
• Utilize motivational interviewing and other therapeutic modalities to skill build around recovery and symptom management strategies
• Lead therapeutic groups teaching interdisciplinary topics, including, but not limited to recovery skills, symptom management, coping skills, communication skills, mindfulness, and physical activity
  
  

Crisis Prevention, Risk Assessment, and Intervention

• Respond to crisis situations and utilize clinical judgement and critical thinking skills to manage and prioritize needs
• Utilize trauma informed practices and DEI awareness to minimize likelihood of crisis encounter
• Utilize risk assessment tools to assess risk of harm to self or others
• Utilize de-escalation practices and connect participant to emergency services as needed
• Complete all required documentation, including incident reports when applicable, within 24 hours of crisis event
• Coordinate respite referrals and entries as well as oversee respite stay
• Coordinate hospital contact and discharge planning
  
  

Administration

• Document all participant contact within 72 hours of service delivery in Electronic Health Record/Credible
• Document all meaningful interactions with participants according to policy and Oregon Administrative Rules
• Utilize outcomes based care tools and review regularly
• Complete monthly and quarterly reporting for housing contracts, as well as maintenance of relevant contract databases
• Complete rental paperwork for individuals in agency housing
• Attend and positively participate in required meetings, including weekly staff meetings and care coordination meetings with prescribers.
• Document case management reviews in Department of Community Justice Tiramisu database and attend regular housing review meetings
• Ensure ROIs and consents are up to date and obtain new paperwork as indicated
  
  

Experience/Qualifications

Experience working with the criminal justice system is preferred. Bilingual in Spanish/English preferred. Applicant must possess the skills necessary to work independently and maintain organization. Must have a firm understanding of medications and their use, administrative rules and other applicable laws and regulations, as well as a firm understanding of acceptable clinical practices and guidelines.

Other General Expectations

• Adhere to Confidentiality, Professional Ethics, and Dual Relationships per policy and Administrative Rule
• Understand and implement Evidenced Based Practices and other therapeutic modalities in all work completed with participants
• Pursue ongoing development of skills and competencies
• Follow all corporate policies, procedures, and protocols
• Maintain current Oregon Driver’s License with ability to transport participants
• Maintain security of all corporate interests
• Maintain CPR and First Aid Certificate
• Maintain QMHA certification
• Core Competencies:
• Communication: Clear, direct, and concise. Keeps people informed. Listens effectively to others.
• Teamwork: Effective at working in team situations.
• Utilizes available resources for personal wellness: Communicates with Supervisor or other designated New Narrative personnel to meet personal wellness and safety needs.
• Adaptability: Ability to modify or change service delivery as needed to best fit the needs of program participants and New Narrative values
• Analytical thinking: Attention to detail over sustained periods of time.
• Dependability: Relied upon to follow through on commitments: at work each day and on time; work completed in a timely fashion.
• Aptitude: Ability to comprehend and apply new ideas, processes and procedures, or training.
• Demeanor: Remaining calm in crisis situations, empathetic, unbiased, non-judgmental and excellent peer model skills.
  
  

Education/Certificates/Licenses/Registration

Qualified Mental Health Associate certification with a Bachelor’s Degree in social work or related field is required.