Peer Support Worker

NORTHERN COUNTIES HEALTH CARE INC•Brighton, VT

4h•Onsite

About The Position

The Peer Support Worker coordinates patient care with members of the integrated health care team. They assess, within the framework of a holistic approach, the biological social, emotional, familial, and financial factors impacting the patient/family’s ability to cope with problems of daily living related to their mental health/chronic disease condition. They collaborate with cross-departmental teams and/or members of partner agencies (schools, DCF, mental health and substance misuse providers) to develop care plans.

Requirements

High school diploma or GED.
Three years of specialized experience which is in or related to the line of work of the position which has provided the applicant with specific knowledge, skills, and abilities to successfully perform the duties of the position.
Knowledge of and the ability to provide integrated service delivery to patients involving social and emotional problems utilizing motivational interviewing.
Knowledge of cultural, social, and economic backgrounds of therapeutic crisis intervention services involving social and emotional problems stemming from medical conditions or diagnosis.
Ability to provide written or oral reports and evaluations concerning program activities, accomplishments, goals and objectives.
Knowledge of existing social and behavioral health resources available for patient care.
Capable of making independent judgements and recommendations for social and psychosocial intervention.
Must maintain a high level of confidentiality.
Strong computer and organizational skills are essential, as well as the ability to multitask, respond to shifting priorities, and to work well under pressure while meeting all required deadlines.
Ability to work independently while demonstrating the skill to work positively within the framework of a team.

Nice To Haves

A Bachelor’s degree in a human services related field.
Experience in a primary care office, or equivalent in meeting chronic care and behavioral health needs of patients.
Lived experience working as a Peer Support with substance use and mental health recovery.

Responsibilities

Coordinates patient care with members of the integrated health care team.
Assesses, within the framework of a holistic approach, the biological social, emotional, familial, and financial factors impacting the patient/family’s ability to cope with problems of daily living related to their mental health/chronic disease condition.
May administer and/or review screening tools to assess and respond to patient needs.
Assesses the patient’s needs and readiness for change using motivational interviewing techniques and builds a therapeutic relationship.
Works with patients to develop a self-management plan for their condition and assists them in achieving their goals.
Provides patient/family educational materials and self-management tools on issues of health maintenance and management of chronic conditions.
Collaborates with cross-departmental teams and/or members of partner agencies (schools, DCF, mental health and substance misuse providers) to develop care plans.
Actively participates in multi organizational care teams and case reviews to provide patients with wrap-around care coordination through diverse community resources.
Meets with patients regularly and performs assessments to determine appropriate behavioral health referral.
Provides individual support to coordinate services across providers and sites of care.
Coordinates referrals to other social services agencies as needed, acting as the patient’s advocate.
Assists with securing low cost and free medications for patients who qualify.
Assists patients with financial assistance through sliding fee applications, hospital financial assistance applications, and insurance applications.
Serves as a resource to staff regarding the resources available to meet social needs of patients.
Informs patients of community services available and communicate with other agencies and community-based organizations on patients’ behalf, as needed to facilitate patient health care needs.
Assures that the necessary communication and information sharing occurs among individuals, families, agencies and providers.
For patients with immediate mental health and/or substance use needs, provide resources and coping tools.
Set goals with the patient for obtaining longer-term behavioral health care and make a referral to a behavioral health or psychiatric provider.
Works with the primary care team to support screening tool protocols. This may include administration, scoring, interpreting, documenting, and treatment planning around results.
Provides brief (30 min) solution- focused behavioral interventions with active development of Behavioral Change planning.
Provides follow up appointments as needed and consistent with our Brief Intervention model of care for a limited duration.
Provides on-site availability for crisis triage, suicide screening and intervention. Provides crisis intervention and utilizes the collaborative assessment for managing suicide (CAMS).
Participate in quality clinical consultation to providers and staff as needed in areas of individual, family, child and adolescent regarding mental health and substance misuse related issues that are directly connected to the patient’s medical condition.
Documents the clinical behavioral health aspect of patient interventions and tracks the patient referrals to specialty behavioral health. Completes and submits in a timely manner all encounter forms for billing purposes.
Attends mandatory staff meetings and committee meetings as deemed appropriate by supervisor.
Completes work assigned accurately and in timely manner.
Demonstrates collegiality and commitment relevant to the mission of Northern Counties Health Care.
Maintains absolute confidentiality of all patients’ records, medical treatments, and diagnoses, and abide by all Northern Counties Health Care policies and procedures.
Maintains a positive and professional attitude in a fast paced and demanding environment and promotes a smooth interface between medicine and specialized mental/behavioral health care throughout the organization.
Analyzes situations and conditions to identify problems, trends and demands for behavioral health services. Makes appropriate program adjustments and monitors change.