Position Summary

The behavioral health coordinator is a core member of the collaborative care team. The behavioral health coordinator is responsible for supporting and coordinating the behavioral, mental, and physical health care of patients on an assigned patient caseload with the patient’s medical provider and, when appropriate, other internal and community behavior and/or mental health providers. The behavior health coordinator will provide short term counseling for patients and caregiver and offer parenting guidance/education for pediatric patients.

Essential Functions

• Support the behavioral, mental and physical health care of patients on an assigned patient caseload. Closely coordinate care with the patient’s medical provider and, when appropriate, other behavioral/mental health providers, schools, and community agencies.
• Screen and assess patients for common behavioral, mental health and substance use disorders. Facilitate patient/caregiver engagement and follow-up care.
• Provide caregiver and patient education about common behavioral, mental health and substance use disorders and the available treatment options.
• Systematically track treatment response and monitor patients (in person or by telephone) for changes in clinical symptoms and treatment side effects or complications.
• Support medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
• Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, cognitive behavioral therapy, motivational interviewing, or other treatments as appropriate.
• Provide or facilitate in-clinic or outside referrals to evidence-based psychosocial treatments (e.g. problem-solving treatment, behavioral activation, etc.) as clinically indicated or based on caseload.
• Participate in regularly scheduled (usually weekly) caseload consultation with the psychiatric consultant, developmental psychologist and/or medical team to communicate resulting treatment recommendations to the patient’s medical provider. Consultations will focus on patients new to the caseload and those who are not improving as expected under the current treatment plan. Case reviews may be conducted by telephone, video, or in person.
• Track patient follow up and clinical outcomes using a registry . Document in-person and telephone encounters in the registry and use the system to identify and re-engage patients.
• Document patient progress and treatment recommendations in Epic and other required systems so as to be shared with medical providers, psychiatric consultant, developmental psychologist and other treating providers.
• Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant and who may need more intensive or more specialized behavioral or mental health care
• Facilitate referrals for patient and/or caregiver that are clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, behavioral/mental health specialty care, substance use treatment).
• Develop and complete self-management plan with patients/caregivers who have achieved their treatment goals and are soon to be discharged from the caseload.

Required For All Jobs

• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.