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The Integrated Behavioral Health Specialist under the direction of the Chronic Care Management Manager, has responsibility to provide care/service safely and efficiently for a full range of services to patients of all ages and their families. Primary role is to collaborate, communicate and facilitate coordination of services using a multi-disciplinary treatment approach that is aimed at identifying and treating behavioral health issues. The Integrated Behavioral Health Specialist will provide an integrated clinical and psychosocial approach to ensure patients receive the behavioral support, short term counseling and crisis intervention in the primary care setting. The Integrated Behavioral Health Specialist will provide direct social work/case management services to patients and/or families and the Care Team to ensure patients receive needed assessments, interventions, support and referrals. This person will work directly with providers and clinic care managers to ensure patients receive appropriate and successful referrals to behavioral health specialists and other community resources. Excellent organizational skills, the ability to work independently and communicate well with others are critical aspects of this position.
Job Responsibility:
Accepts responsibility and accountability for achievement of optimal patient outcomes within their scope of practice
Adheres to all the University of Kansas Health system policies, procedures, and standards and complies with the Corporate Compliance program
Accepts calls as required by position and department expectations
Performs job specific responsibilities and demonstrates accountability for own actions and decisions
Acquires and maintains knowledge and competence related to the expectations of their position and practices within their scope
Brings ideas and concerns to supervisor and participates in department decision making
Completes psychosocial assessments of patient/family situations as needed including social, psychological, emotional, financial, and other socioeconomic factors
Identifies and utilizes all relevant information related to patient’s current condition(s) to assess the patient’s psychosocial situation accurately and thoroughly
Responsible for crisis intervention, problem solving, brief solution-focused interventions, cognitive behavioral therapy, and self-management support for referred patients
Participates in team huddles and meetings among the care team and clinic(s)
Works collaboratively, cooperatively, and independently as a member of the clinical care team
Provides strategic and goal-orientated sessions with patients focusing on brief solution-focused interventions
Assists patients and/or their families in obtaining community behavioral health referrals
Follows-up on patient referrals to ensure the patient has received the needed services
Responsible for telephone call follow-up for high-risk patients on caseload, especially depressed patients
Recognizes the importance of cultural diversity, age/developmental level, and respects individual preferences
Responsible for development of exemplary working relationships with patients, their families, and representatives
Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes
Advocates for patient’s rights to self-determination unless a patient’s action or goals pose a serious, foreseeable, and imminent risk to themselves or others
Monitors cognitive functioning of patients
Reviews the patient plan of care with the multi-disciplinary team
Documents in the medical record (EMR) and verbally communicates with the care team to coordinate interventions and facilitate continuity of care
Demonstrates knowledge of community-based social services and resources in the metropolitan and other key areas of the patient population
Identifies key social and environmental factors in patient’s lives including resource needs, stressors, and interpersonal problems
Responsible for follow-up on Social Determinants of Health (SDOH) for patient’s needs such as (but not limited to): transportation, social isolation, prescription assistance, health care costs, housing cost
Maintains a safe, comfortable, and therapeutic environment for patients and families in accordance with The University of Kansas Health System standards
Maintains clinical Social Work licensure and CEU’s
Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department
Requirements:
Master's Degree in Social Work
Experience in a health care setting, integrated primary care environment behavioral health or social service agency
Licensed Specialist Clinical Social Worker(LSCSW) - State Board of Behavioral Sciences Kansas or Missouri