Integrated Care Coordinator - Spokane, United States - Spokane County, WA

Description

Job Summary

(1) vacant positions at 37.5 hours per week.

The position allocated to this classification performs professional and/or administrative duties, providing behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health services for eligible individuals. Under the direction of the Integrated Behavioral Healthcare Manager, work is performed with considerable independence and evaluated on the attainment of the assigned division(s) and the associated program goals and objectives. There are three Integrated Care Coordinator areas of assignment within the Community Services Department (CSD): Behavioral Health Agency Clinical Integrated Care, the Behavioral Health Administrative Services Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review Integrated Care.

Note: Three (3) professional references are required.

TOTAL COMPENSATION:$85,812 - $120,126 annually.Total compensation is anestimatebased upon base compensation, median retirement fund contributions, and current employer-paid health and related benefit contribution rates (including medical, dental, life insurance, long term disability, and leave). The actual total will vary depending upon each employee's enrollment choices.

Examples of Duties

Behavioral Health Agency Clinical Integrated Care Coordinator:

Follows the laws of the State of Washington and the federal government as they pertain to mental health practice.

Completes all training required by the WAC and RCW's within the required time frames.

Attends training to improve clinical skills.

Adheres to Service Encounter Reporting Instructions.

Maintains records in accordance with requirements of law, contractual requirements and agency policy.

Provides individual, family, and group counseling.

Practices standards for managed care as it applies to clinical practice.

Provides person centered care services in a culturally sensitive manner.

Provides mental health assessments, develops and implements treatment plans, provides case management referral and care coordination with other mental health professionals, allied treatment providers, and other community partners.

Provides crisis intervention services when needed and stays familiar with crisis policies and procedures.

Participates as a team member of this Agency by attending staff meetings and actively participating in agency meetings.

Attends regular supervision with the Integrated Behavioral Healthcare Manager to maintain quality of care; responds to requests from supervisors in a timely manner; uses time effectively; keeps appointments and is at work and meetings on time.

Encourages and participates in community networking; supports treatment team meetings developed by other agencies; and attends community meetings as requested and approved by supervisors.

Performs other related duties as required/assigned.

Behavioral Health Administrative Services Organization Integrated Care Coordinator:

Provides direction and guidance to individuals, contracted providers, and allied systems to assure alignment with the CSD mission and desired outcomes.

Stays abreast of hospital daily census and of the reasons for admissions and discharges or lack of movement toward discharge.

Collaborates with Utilization Review Integrated Care Coordinator regarding continued inpatient stay requests for eligible individuals by reviewing clinical documentation for required Medical Necessity Criteria; through telephonic consultation and record review; offers clinical opinions regarding level of care, duration, and intensity of care when deemed needed.

Monitors discharge tracking to ensure compliance with first follow-up appointment and treatment status 30 days post discharge for eligible individuals whose behavioral health services are funded with non-Medicaid funds.

Tracks and monitors applicable inpatient readmissions within sixty (60) days and the reason for such.

Convenes community care conferences with providers to review and evaluate coordination of care and identify necessary resources to prevent further recidivism.

Participates in the team meetings for children and adults at the community inpatient psychiatric hospitals.

Provides oversight, education, and consultation to referring providers and CSD contracted programs that divert adults or children from intensive services to promote maximum utilization.

Maintains collaborative and collegial working relations with all provider employees, allied system staff, inpatient staff, diversion resource staff, individuals, and their families.

Builds and maintains strong system working relations within the behavioral health delivery system and with allied service systems.

Promotes evidence-based practices (EBPs) among the CSD contracted provider agencies and develops evaluative tools to determine if the EBPs are successful for individuals in services.

Defines effective and efficient referral and communication protocols between the CSD and each contracted agency.

Encourages the implementation of person-centered services and shares information about newly emerging person-centered models and programs.

Provides technical assistance to contracted agency staff on a proactive basis by responding to agency requests.

Participates in annual monitoring of the CSD funded providers.

Organizes or participates in community or Spokane County Regional Behavioral Health (SCRBH) meetings and committees as appropriate.

Attends the Statewide Eastern/Western State Hospital Liaison meeting representing the SCRBH (ASO) as the ASO hospital liaison, and to incorporate changes made by the State regarding care coordination of services to individuals assigned to the ASO currently at the State Hospital.

Develops comprehensive policies and procedures for compliance with state and federal regulations and to facilitate CSD operations as requested by CSD leadership.

Participates in the CSD licensure certification reviews, state audits, program monitoring, and/or audits, as required by leadership.

Under the direction of the Integrated Behavioral Healthcare Manager , develops, implements, and oversees new programs and projects as required in the SCRBH (ASO) contract with the HCA and to improve the behavioral health system of care

Create, develop, and submit regular progress reports on the development of program plans and ongoing program activities to ensure full compliance with statewide program standards and contract requirements.

Completes and submits contractually required deliverables and reports within the timeframes required, ensuring accuracy, quality, and timely response.

Implements effective and efficient project management procedures to ensure timely completion of projects. Provides clear assignments, common formats for their outputs, disciplined timelines, coordinated meeting schedules, communication mechanisms, and review processes.

Coordinates and manages projects and project improvement on an ongoing basis as directed by CSD Leadership. Ensure compliance with program standards, contract requirements, and quality improvement standards.

Provides cross coverage functions for the CSD Integrated Behavioral Healthcare Project Coordinators, Integrated Care Coordinators, and lower level positions in CSD.

Communicates regularly with leadership to keep them abreast of activities, plans, and concerns.

Plans, organizes, and advocates for wellness committee for the staff in the division by providing fun activities, engagement, support, and innovative bonding.

Works closely with and acts as liaison between contracted outpatient behavioral health providers, crisis providers, criminal justice & criminal court partners, Law Enforcement, physical health providers, regional partners, community stakeholders, hospital diversion resources, and other system partners to facilitate access to behavioral health services, enhance diversion efforts, and assist in identifying challenges and addressing barriers to accessing necessary behavioral health services.

Facilitates the intensive treatment team meetings for all detained and committed youth and for voluntary youth whose inpatient stay are funded with CSD non-Medicaid funds and who demonstrate symptom exacerbation or outcome changes and/or disposition placement challenges to provide expert consultation and facilitation of discharge.

Coordinates the Children's Long-Term Inpatient Program (CLIP) for CSD funded individuals and their families; participates as the region's CSD representative for State Care Coordination; provides education and diversion resources for families and providers; determines guidelines and appropriateness for children being considered for placement.

Participates in the CLIP Screening Review Team; coordinates provider and family presentations.

Provides technical assistance with CLIP applications for youth and families not enrolled in Medicaid. In collaboration with the primary provider, provides rehabilitative case management during CLIP hospitalization and facilitates timely discharge in collaboration with primary provider and CLIP facility treatment team for youth who are not enrolled in Medicaid.

Facilitates the CSD inpatient treatment and residential team meetings to assist and determine placement for individuals for community integration. This would include individuals coming from Department of Corrections release, as well as inpatient, or when needed within the community to ensure continuity of care and appropriate placement.

Participates in and facilitates as needed the Substance Use Disorder system of care meetings.

Coordinates with outpatient and inpatient residential substance use disorder behavioral health agencies and co-occurring programs.

Assists with placement for individuals for community integration. This would include individuals coming from Department of Corrections release, as well as inpatient, or when needed within the community to ensure continuity of care and appropriate placement.

Participates in technical assistance provided by the Law Enforcement Assisted Diversion (LEAD) National Support Bureau.

Performs other related duties as required/assigned.

Behavioral Health Administrative Services Organization Utilization Review Integrated Care Coordinator:

Performs utilization management, utilization review, or concurrent review of behavioral health inpatient and outpatient care management.

Determines medical necessity for inpatient and outpatient services following evaluation of guidelines and benefit determination.

Consults with the Medical Director for any service authorization denials.

Determines financial eligibility which involves utilizing the State of Washington's Provider One system to clarify the correct funding stream for both outpatient and in-patient services.

Identifies solutions to non-standard requests.

Provides education, updates, feedback and guidance to contracted providers to ensure individuals are getting quality care.

Stays abreast of hospital daily census and of the reasons for admissions and discharges or lack of movement toward discharge.

Collaborates with Integrated Care Coordinators regarding continued inpatient stay requests for eligible individuals by reviewing clinical documentation for required Medical Necessity Criteria; through telephonic consultation and record review; offers clinical opinions regarding level of care, duration, and intensity of care when deemed needed.

Maintains collaborative and collegial working relations with all provider employees, allied system staff, inpatient staff, diversion resource staff, individuals, and their families.

Builds and maintains strong system working relations within the behavioral health delivery system and with allied service systems.

Monitors utilization data to identify system efficiencies and deficiencies and assists with the development and implementation of new resources and programs.

Reports findings to the CSD leadership and the adult and/or child provider allied systems committee.

Provides cross coverage functions for the CSD Integrated Behavioral Healthcare Project Coordinators, Integrated Care Coordinators, and lower level positions in CSD.

Communicates regularly with leadership to keep them abreast of activities, plans, and concerns.

Works closely with and acts as liaison between contracted outpatient providers and hospital diversion resources to facilitate access to diversion resources and to assist in identifying challenges and addressing barriers to utilization.

Performs other related duties as required/assigned.

Minimum Requirements

EDUCATION AND EXPERIENCE REQUIREMENTS

Master's degree from an accredited institution in mental health counseling, social work or other closely related field.

Education, training or experience, which clearly demonstrates knowledge and skills related to the treatment of behavioral health disorders.

May not be a State or Federal (OIG) and System for Award Management (SAM) excluded provider, in any capacity for the Medicare, Medicaid, and all Federal healthcare programs.

Must successfully pass a background check and driving record check.

ADDITIONAL MINIMUM REQUIREMENTS (Depending Upon Area of Assignment)

Behavioral Health Agency Clinical Integrated Care Coordinator:

Must be designated as a Mental Health Professional with the knowledge and skills to complete full diagnostic assessments with the ability to formulate DSM 5 diagnoses.

Possess a valid State of Washington issued credential to practice as a counselor, without restriction, probation, or limiting condition or threat thereof, or proof of application must be provided within 30 days of beginning employment.

Possess a valid National Provider Identification Number (NPI), or proof of application must be provided within sixty (60) days of beginning employment.

Maintain professional credentials required for the service being provided. Including CEU credits as needed to maintain credentials.

Behavioral Health Administrative Services Organization Integrated Care Coordinator:

Two (2) years of direct behavioral health clinical experience with emphasis on acute psychiatric and co-occurring disorders of adults and children with high level knowledge of the behavioral health system; including applicable federal, state and local regulations, federal and state behavioral health funding, care transitions across the continuum of care, and behavioral health grant writing, program development, and contract compliance.

Individuals with active Washington State Department of Health (DOH) Substance Use Disorder Professional (SUDP) credential or and/or licensure as a Mental Health Counselor, Clinical Social Worker, Marriage and Family Therapist, or Licensed PhD or PsyD in Psychology or a related field is highly preferred.

Behavioral Health Administrative Services Organization Utilization Review Integrated Care Coordinator (ICC):

Requires Washington State Department of Health licensure as a Mental Health Counselor, Clinical Social Worker, Marriage and Family Therapist, or Licensed PhD or PsyD in Psychology or a related field.

Three (3) + years of direct behavioral health clinical experience with emphasis on acute psychiatric and co-occurring disorders of adults, older adults, transition age youth, and children.

Licensure must be current and unrestricted in the state of Washington.

ICCs who make service authorization decisions for children and youth must be designated as a Child Mental Health Specialist.

ICC's who make service authorization decisions for substance use disorder treatment must have a current DOH Chemical Dependency Professional/Substance Use Disorder Professional credential with experience and knowledge of substance use disorders and medication assisted treatment.

Selection Factors

Knowledge of relevant federal, state, and county policies, procedures, and regulations to include HIPAA and 42 CFR, Part 2.

Knowledge of acute psychiatric symptoms and diagnoses.

Knowledge of substance use disorder symptoms and diagnoses.

Knowledge of managed care and utilization review required.

Knowledge of the relevant system of care for Adams, Ferry, Lincoln, Pend Oreille, Spokane and Stevens counties.

Knowledge of fundamental understanding of DSM 5, or its successor, psychiatric disorders, psychotropic medications, brain physiology and demonstrate a working knowledge of the various theoretical models of psychotherapy, behavioral counseling and other Evidenced Based Practice treatment.

Knowledge of Service Encounter Reporting Instructions and contractor requirements with the ability to provide technical assistance to contracted behavioral health agencies as needed.

Knowledge of best practice standards for acute psychiatry evaluation and treatment.

Knowledge of best practice standards for substance use disorder assessment and treatment.

Knowledge of utilization management of public behavioral health.

Knowledge of federal regulations and state laws applicable to public behavioral health.

Knowledge of BHO Service Encounter Reporting Instructions.

Knowledge of contract administration and compliance.

Knowledge of group facilitation skills towards consensus based and target outcomes.

Knowledge of public and private behavioral health providers and community resources and programs available to individuals with identified needs.

Knowledge of collaborative case planning and care coordination.

Knowledge of person centered treatment and recovery models.

Knowledge of computer applications related to the work including proficiency in Microsoft Word and Excel.

Knowledge of record keeping principles and practices; correct business English, including spelling, grammar, and punctuation.

Knowledge of techniques for dealing with a variety of individuals from various socio-economic, ethnic, and cultural backgrounds, in person and over the telephone.

Knowledge of programs and eligibility requirements for the Social Security Administration, Washington State Medicaid, regional social services and food stamps, and other relevant programs.

Skilled in communicating effectively both orally and in writing, sufficient to exchange or convey information and to give and receive work direction.

Skilled in establishing and maintaining effective working relations with all personnel, including, federal and state agencies, local government agencies and associations, and community and development service agencies and committees.

Skilled in the use of personal computer including the use of spreadsheets.

Ability to apply standardized Medical Necessity Criteria to determine lengths of stay and continued care.

Ability to efficiently refer to and effectively utilize county funded community resources for the least restrictive level of care.

Ability to communicate exceptionally well orally, in writing, and over the telephone.

Ability to analyze, interpret, apply, and explain utilization data.

Ability to assess cases appropriately and utilize the most appropriate community resources to provide effective client services.

Ability to prepare clear and concise reports, correspondence, and other written materials.

Ability to use initiative and independent judgment within established procedural guidelines; organize own work, set priorities, and meet critical deadlines.

Ability to establish and maintain effective working relationships with those contacted in the course of the work.

Ability to perform all related duties with accuracy and efficiency.

Ability to exercise discretion and independent judgment in all areas of job performance including adherence to appropriate professional boundaries and strict confidentiality practices in regard to client activities and documentation.

Ability to apply clinical judgment, ethics and accountability to formulate and implement treatment plans and other clinical documentation.