Case Manager- Homeless Outreach

Family & Children's Services•Tulsa, OK

9h•Onsite

About The Position

The Certified Behavioral Case Manager will work in partnership with others as part of a structured inter-disciplinary team, within in a Certified Community Behavioral Health Center (CCBHC) model, to provide a set of social service functions that helps clients access the resources they need to recover. The CCBHC is an integrated community behavioral health model of care intended to provide integrated, evidence-based, trauma-informed, recovery-oriented and person-and-family-centered care. The CCBHC offers the full array of CCBHC-required mental health, substance use disorder (SUD) and primary care screening services. Services are predominantly delivered to an adult population who are experiencing homelessness, carry a serious mental illness, substance abuse, co-occurring and/or medically co-morbid diagnosis.

Requirements

Bachelor’s Degree in the social sciences field is preferred. Consideration may also be given for degrees in Criminal Justice or Education.
Case Management Certification or obtain by taking the first available Case Management Certification course provided by ODMHSAS after hire.
Must have a strong commitment to the right and ability of each person served to live in normal community residences; and have access to helpful, adequate, competent, and continuous supports and services.
Skills and competence to establish supportive trusting relationships with persons with mental illnesses and/or substance abuse issues and respect for client rights and personal preferences in treatment are essential.
Must possess a valid Driver License and satisfactory driving record and use personal automobile to travel to locations other than primary office. Mileage reimbursement provided

Responsibilities

Attend and participate in daily organizational meetings and treatment team meetings with multi-disciplinary team to utilize a team based care approach when working with clients.
Document client progress to maintain a permanent record of client activity according to established methods and procedures.
Demonstrate understanding of various best-practice treatment models to work with individuals with Severe Mental Illness, Co-occurring disorders, and trauma.
Understand the wrap-around focus of CCBHC services, assisting clients in multiple life areas through multi-disciplinary teamwork and community referral.
Obtain and maintain professional licenses and certifications required for the position through attending required trainings, tracking CEU’s, and submitting renewals in a timely manner.
Be familiar with CCBHC standards, understand the history, philosophy, structure and purpose of CCBHC and demonstrate fidelity to the model.
Effectively complete and submit all clinical documentation with established agency timelines.
Plan, coordinate, advocate, and provide care coordination, case management, and rehabilitation services using a strengths based, welcoming, recovery oriented, client driven approach for a specified group of clients.
Coordinate care across the spectrum of health services, including access to high-quality physical (both acute and chronic) and behavioral health care.
Include the consumer and family members in comprehensive treatment planning. With the adult consumer’s consent, encourage participation of family members and other designated persons in treatment planning and care.
Participate in daily/weekly treatment teams. (daily huddles)
Coordinate care with external health care providers such as pharmacies, PCPs, FQHCs, and DCOs, as well as with behavioral health referrals.
Complete initial wrap plans, strengths and culture discoveries, and intakes as needed. Update and modify wrap and treatment plans as needed, or on a scheduled basis.
Promote access on demand to intervene when a client is at risk for harm to self or other, hospitalization, or involvement with law enforcement. Respond to crises and provide intervention.
Track consumers’ admissions and discharges from psychiatric and medical hospitalizations.
Participate in hospital and emergency department discharge processes to transition consumers to a safe community setting according to CCBHC protocols. Ensure timely transfer of medical records, prescriptions, and active follow-up.
For consumers at risk for suicide, coordinate consent and follow-up within 24 hours and implement a continuing plan for suicide prevention and safety and linking to services.
Monitor individual health status and service use to determine adherence to or variance from treatment guidelines.
Actively participate in performance and client outcome management.
Accompany individuals to medical appointments. Link to non-medical enabling functions and provide assistance with community resources such as housing, social services, education, and employment to facilitate wellness and recovery of the whole person.