About Job

Description

Oversees the Care Coordination team and provides ongoing training, supervision, education, and support.
Assists in the completion of annual performance evaluations and quarterly goal review.
Oversees the Resource Navigator position and provides ongoing support in the development and implementation of processes for providing support to departments, clients, and families for resource identification and connection.
Oversees all care coordination tasks and responsibilities, including: initial discharge planning needs assessment post admission; discharge/aftercare planning for clients discharging from intensive services; coordination with acute inpatient hospital teams; step down logistics; family support and communication; completion of discharge clinical assessments and surveys.
Assists the care coordinators with unexpected discharges as a result of financial barriers, AMA discharges, or expulsions
Ensures timely completion of discharge plans and discharge instructions for approval by the treatment team by the day of the client’s discharge.
Ensures completion of all discharge-related tasks prior to a client’s discharge date.
Oversee care coordination support during the hospitalization process for clients in need of a higher level of care. Oversee the ongoing coordination of care with the hospital, family, and treatment team to provide updates, ensure continuity of care, and ensure all tasks are completed as needed for each hospitalization process.
Conducts weekly and monthly audits of care coordination related tasks to ensure compliance with completion of tasks within identified time frames.
Oversees the process of ensuring all clients have the correct level of care, treatment team, and recovery track in the EHR; provides updates to the clinical team on completed level of care changes and discharges; oversees the process of completing daily attendance for DT/IOP clients
Oversee, assist, and support the development and maintenance of relationship with community partners, including sober living programs, psychiatric hospitals, and referral partners.
Coordinate off-site transportation with the residential/transportation staff for residential clients who have off-site appointments or require Skyland transportation support.
Liaisons with recovery residences in the community to coordinate admission for residential clients transitioning to PHP, including tours, interviews, transition plans and building relationships with recovery residence staff. Maintains current program information on recovery residences in community.
Manages a caseload of clients for all care coordination related needs, including (but not limited to): family communication, case management needs, step down planning, discharge/aftercare planning, and coordination of hospitalizations.
Meets with clients to discuss and develop individualized discharge plan. Works with the treatment team to identify needs for outpatient services and identifies options for outpatient providers based on psychiatrist discharge order. Has knowledge of clients’ course of treatment and goals. Utilizes case management skills, such as advocacy, transition and discharge planning to link clients to resources and services. Compiles all clinically significant information relevant for developing and finalizing the discharge plan/instructions.
Ovessees the coordination of case management related needs within the care coordination department, including: collection of additional records or collateral information post-admission; coordination of community-based appointments in conjunction with the Wellness Clinic
Notifies recovery team of any changes in clients’ mental status and/or behavior, issues or concerns with step down/discharge planning, or issues expressed by family. Supports ongoing open communication among client, recovery team, psychiatrist and family, as necessary.
When appropriate, assists, teaches, and models daily living skills, healthy boundaries, and communication skills.
Attends weekly clinical supervision. Attends weekly scheduled supervision with the Care Coordination Director for administrative supervision, direction, and case consultation. Attend Day Services meeting twice monthly and disseminates relevant information to CC team as appropriate.
Attends community meetings, client engagement meetings, and mandatory in-services hosted at Skyland Trail, as well as other clinical trainings and learning opportunities deemed important by clinical supervisors.
Complies with facility policies and accreditation standards
Participates in continuing education programming in accordance with state licensing body and goals of specific recovery communities assigned
Supports Recovery Communities as directed by the Care Coordination Director and Day Services Director
Other duties as assigned

Qualifications

Bachelor’s degree in a related field (psychology, social work) and 2+ years of related work experience
Prior management/supervisory experience preferred
Prior case management experience preferred.