The BHCM is responsible for coordinating and integrating Behavioral Health services. The Clinical Navigator will make linkages within the hospital and the wider community for supportive services. Provides Care Coordination services to patients based on person-centered treatment and coordinates patient care within an interdisciplinary team setting. Contributes to a cooperative and accountable working relationship with other members of the Care Coordination system staff toward the goal of providing continuous services. Promotes optimal person-centered care that supports and empowers individuals, respects individual choices, and meets health care needs of patients. Provides consultative role as BHCN to clinical and non-clinical departments. Assists with retrospective reviews and medical necessity denials per communication with third party payors. Communicates and negotiates appropriate length of stay and obtains prior and continuing authorizations with managed care providers and third party payers. Provides assistance to patients and families through evaluation of social, emotional, and financial needs and coordinates appropriate resources to ensure continuity of care across the behavioral health continuum through discharge planning and utilization review functions. Responsible for rendering services in a variety of settings to include the ED, Behavioral Health Unit, and inpatient medical floors.
EDUCATION: Master's in Counseling, Master's in Social Work or other relevant field eligible for licensure.
CERTIFICATION/LICENSES: New Mexico LPCC, New Mexico LCSW, or LMHC, LMSW with attainment of full associated NM licensure within 6 months, CPI certification required (hospital provided).
Knowledge working with diverse populations struggling with substance abuse and behavioral health issues
Considerable knowledge of health care facilities, policies and issues, and of the full spectrum of community patient care services
Considerable knowledge of health care and social management principles, practices and procedures
Commands a full understanding of BH issues and barriers to care, with intensive clinical case management of high acuity populations
Ability to coordinate various functions and activities for maximum cooperation and integration of services providers and persons receiving care within a variety of clinics for continuum of care services
Ability to direct, instruct and advise staff, and to receive and effectively react to day-to-day problems
Ability to utilize strong communication skills, both written and oral, and effectively demonstrate an interactive style of care coordination
Ability to understand and implement sensitivity and culture of care measures appropriate to a diverse population
Ability to work with various levels of the organization including clinical, financial, administrative and medical staff
Ability to coordinate multiple departments, as well as community agencies, to reach collaborative goal
EXPERIENCE: Two years' experience working with behavioral health and substance abuse issues. Prior experience working within a hospital/clinic environment preferred.
NATURE OF SUPERVISION: - Responsible to: Clinical Manager
-Bloodborne pathogen: B
Multiple settings and variable unpredictable situations . May work in ED or inpatient setting. May work irregular hours. Multiple simultaneous activities around patient care. Exposure to infectious diseases. Subject to varying unpredictable situations.
PHYSICAL REQUIREMENTS: Must be able to handle emergency/crisis situations, prolonged, extensive or considerable standing. Has knowledge of and uses good body mechanics. Hearing and visual acuity must be within normal limits. Manual dexterity and fine motor coordination required. Ability to move around settings of care. Requires close work, good vision, dexterity to write as well as to use computer keyboard.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.