The OTP (Opioid Treatment Program) Medical Case Manager will provide care management consultation to clinical care teams for individuals experiencing complex medical, substance use disorder, and behavioral health needs following up on emergency department visits and hospital admissions.
Under the direction of the lead case manager, this position will develop collaborative relationships between patients, the ETS clinical care team, and external medical providers to support outreach, engagement, and care navigation with an emphasis on ensuring access to primary medical services. Through the use of a registry with data compiled from Collective Ambulatory Technology, the individual will serve as a liaison between clinical informatics, clinical care teams, and community providers to support linkage to services that reduce avoidable emergency department utilization, hospital re-admissions, and support care transitions from inpatient hospital admissions. This position will act as a conduit of communication between medical professionals, agency partners, community resources, and patients. Case managers will provide patient-centered services from a harm reduction perspective utilizing motivational interviewing skills. The nature of this position is extremely independent, requiring creative and critical thinking, multitasking, time management and management and organization skill, and conflict resolution skill.
Job Functions (May Include):
Utilize registry with data compiled from Collective Ambulatory Technology for population health management to triage patients for care management support.
Enter data to complete HEDIS related to outcome measures.
The ability to plan and consultant with clinical care teams to make adjustments in treatment for a patient when outcome goals to reduce emergency department utilization is not reached.
Collaborate with providers to ensure outreach, engagement, intensive case management, and care coordination services for assigned patients.
Assist care team and patients with communicating and establishing or maintaining medical care to address chronic health conditions; thereby, reducing emergency department utilization and inpatient hospitalizations.
Address patient’s needs for mental health and substance use disorder treatment services to facilitate and support engagement with appropriate outpatient services.
Meet patients in the community (hospitals, primary care providers, etc.,) to explain offered services and establish a working relationship with ETS clinical care team and external patient providers.
Develop rapport and a trusting relationship with patients through respectful outreach and patient-centered engagement practices.
Develop and implement in collaboration with the patient, an individualized Service Plan which addresses the patient’s needs and priorities. Review and update this plan regularly to reflect progress or attainment of articulated goals and the emergence of new patient needs and to help the patient move toward the achievement of autonomy.
Assess the nature and severity of a patient’s substance use disorder issues and match clinical interventions to everyone’s stage of change, focusing on reducing the harmful consequences of substance use through self-change methods.
Develop and maintain productive working relationships with community programs that may support patients to provide effective coordination of care.
Provide services consistent with ETS policies and procedures.
Assist patients in keeping appointments.
Advocate for the patient with a wide variety of ETS clinical care team and external providers services.
Assist with accessing needed services by setting up and attending appointments with patients to provide continuity of care.
Identify gaps and barriers in available community resources and advocate for systemic changes.
Attend ETS team meetings and other required meetings.
Utilize clinical supervision, psychiatric consultation, and peer support for exploring clinical intervention strategies, countertransference, resource development, self-care and burnout prevention.
Develop and maintain patient files for assigned caseload according to Agency, contract, and state requirements.
Local travel on behalf of the Agency is a job requirement.
Additional duties as assigned.
Qualification Requirements Education
Bachelor’s Degree in Social Sciences, ex: Social Work, Psychology and Sociology, etc.
Medical Assistant is preferred.
Academic training in the social service field and in the area of substance use disorder and mental health treatments desired.
SUDP/SUDPT and MSW’s highly desirable but not required.
2 years in a Case Manager role.
The ability to respectfully engage and develop a working partnership with the people we are serving is essential.
Understanding of harm reduction along with a demonstrated passion for serving individuals experiencing homelessness, substance use, and co-occurring disorders required. Street outreach experience is a plus.
Ability to advocate and effectively communicate and problem solve under pressure in high stress situations.
Computer literate, with basic knowledge of Microsoft Office Suite, as well as a high level of initiative in keeping current with technological change.
Ability to prioritize workload and daily activities to complete tasks in a timely and efficient manner.
Ability to set boundaries, resolve conflict, and de-escalate issues.
Dependable, able to work under pressure, receptive to change, willingness to learn a cooperative approach to problem-solving.
Ability to establish and maintain effective working relationships with staff, participants, and outside contacts from a wide variety of ethnic, socioeconomic, and cultural backgrounds; good diplomatic skills.
Possession of a valid Washington State Motor Vehicle Operator’s License with acceptable driving record (local travel on behalf of the agency is a job requirement)
Must be able to pass a Washington State Patrol criminal background check.
Flexible team player.
Excellent attention to detail.
Ability to read and interpret general business correspondence, policies, and procedures, referral information, financial documentation, and applicable government regulations.
Ability to write business letters, uncomplicated reports, instructions, and procedures.
Ability to present information effectively and respond to questions from patients, staff, referral sources, and the general public.
Mathematical Skills and Reasoning Ability
Thorough knowledge of and ability to apply business arithmetic skills accurately and rapidly.
Ability to solve practical problems and deal with a variety of concrete variables in situations where standardization may be limited. Ability to interpret a variety of instructions furnished in written, oral, schedule, or diagram format.
Ability to interpret a variety of instructions furnished in written, oral, schedule, or diagram format.
The employee is regularly required to sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms and talk or hear; frequently required to stand, walk, and kneel; occasionally to climb balance, or stoop; rarely to crouch or crawl.
The employee must occasionally lift and/or move up to 30 pounds. Specific vision abilities required by this job include close, color, and peripheral vision and the ability to adjust focus. The noise level in the work environment is moderate.
Equipment Used Computer, photocopier, fax machine, and phone.