CARE COACHING - CLINICIAN

REPORTS TO: DIRECTOR - SYNERGY OPERATIONS
SUPERVISES: None

JOB SUMMARY: The Care Coaching Clinician position is responsible for conducting day-to-day care coaching activities, and any related activities, in accordance to the Care Coaching policies and procedures.  This individual’s responsibilities include the management of assigned cases to ensure members have access to appropriate health care services and return to maximum functional capabilities.  Care Coaches assess the needs of members through the use of internal, computer-based clinical assessments and coaching interventions via telephone.

MINIMUM QUALIFICATIONS:

Education:		Licensed healthcare professional (RN, LPN, LCSW, LMHC, LMFT) with a current, unrestricted license where such licensure is available.
Experience:		Direct consumer/patient care in behavioral health required Two years clinical experience in case management and/or mental health required. One-to-two years critical care experience/crisis management in medical practices or  behavioral health practices preferred. Two to three years clinical call center experience preferred.
Knowledge/skills:		Strong communication, documentation, clinical (behavioral health), critical thinking, and problem solving skills are essential; Able to work in a team environment, must be flexible and able to adapt to a changing environment; Able to work in an environment with goals, objectives and operational metrics; Strong skills in dealing with difficult and challenging personalities and situations are essential; Excellent typing and computer skills, and ability to collect data as assigned for reporting purposes; Ability to communicate and work with a multidisciplinary team (internal and external) to facilitate day-to-day workflow; Call center knowledge desirable.

ACCOUNTABILITIES:

Overall Job Performance/Responsibilities:

• Adheres to goals and objectives (i.e., health care cost containment; high quality of health care delivery system; meeting the member's individualized health care needs; adherence with treatment regimen; returning member to maximum functional capability) through adherence to program policies and procedures;
• Performs telephonic care coaching activities, communicating with the multidisciplinary team in the timeframes required to meet program goals and objectives;
• Collects pertinent clinical information, documenting findings using the HI care coaching information system program;
• Summarizes and documents pertinent member data (i.e., verbal discussions with the member/member's legally appointed representative, family, practitioner, other health care providers or the health purchaser staff, and/or any conferences);
• Refers cases to where there is a threat of litigation and/or refers members specified by the legal department for immediate referral.
• Provides for supervision of non-clinical staff in the disease management program by licensed or certified staff.
• Work to ensure all programs effectiveness, quality, productivity profitability and patient safety.
• Identifies and communicates to supervisor all concerns related to patient safety issues.
• Consults with and seeks advice from licensed physicians with expertise appropriate to the types of services being managed. 

Customer Services-Internal:

• Creates and supports a positive and supportive working environment;
• Maintains a courteous and professional attitude when working with all HI staff members and the management team;
• Actively participates in any team meetings and Grand Rounds.
• Actively participates in any HI committee meetings as assigned; 
• Serves as a positive role model for peers.
• Ensures that licensed health professionals are readily available to answer questions and that non-clinical administrative staff is performing within the scope of the non-clinical role.

Customer Services-External:

• Works, communicates and collaborates in harmony and in a courteous and professional manner with members, practitioners, providers, health purchaser clients and their staff, and the HI multidisciplinary team;
• Timely processes and communications, identifies and resolves all issues and concerns related to the day-to-day activities as assigned/designated; 

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