The Collaborative Care Social Worker is a member of the InterMed Behavioral Health Team and is responsible for management of patients in a primary care and/or specialty care setting, supporting InterMed’s collaborative care program. The Collaborative Care Social Worker provides short term counseling, care coordination and identifies and reduces barriers to care in regard to mental healthcare in the primary care setting. The Collaborative Care Social Worker uses treatment-to-target care plans to help patients reach their goals.

ESSENTIAL FUNCTIONS

Patient Care

• Conduct psychosocial assessments and/or diagnostic evaluations.
• Identify and use short-term counseling and/or targeted brief behavioral interventions with primary care patients and their families appropriate to patient’s diagnosis and presenting problem.
• Develop, coordinate and communicate treatment plans with patients, families, the primary care team and the behavioral health team to achieve treatment plan goals.
• Build resources within family units and help to locate effective support for family members within their communities
• Provide direct patient education and care for treatment of common mental health and substance abuse disorders
• Maintain unconditional positive regard for patient and their family
• Monitor patient progress and goals, provide appropriate follow-up services
• Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant

Collaboration

• Work collaboratively to coordinate care with other members of the behavioral health team and with InterMed primary care providers.
• Provide education and training on the management of behavioral health concerns to the primary care team
• Provide consultation to primary care providers and other staff regarding patient behavioral health concerns
• Provide or facilitate outside referrals to evidence-based psychosocial treatments as clinically indicated.
• Develop and maintain relationships with community based mental health providers who utilize evidence-based psychosocial treatments for purposes of referral and collaboration
• Participate in case consultations to NPPA care managers and psychiatrist

Operations

• Maintain detailed patient progress notes and clinical notes providing diagnosis, treatment goals, progress made towards goals, and discharge criteria in EHR so as to be shared with medical providers, psychiatric consultant, and other treating providers.
• Understand Collaborative Care Model workflows and tools, including the behavioral health registry.
• Participate and department continuous improvement work.

JOB REQUIREMENTS

• Master’s degree from accredited school in Social Work or Clinical Counseling
• Active, unencumbered Maine licensure to practice as a LCSW, LMSW or LCPC is required
• Licensed Alcohol and Drug Counselor preferred
• 3 years of related work experience in a health or mental health setting preferred
• Excellent interpersonal skills, communication skills, and ability to work collaboratively in a team environment
• Working knowledge of evidence-based psychosocial treatments and brief behavioral interventions for common mental health disorders, when appropriate
• Experience with assessment and treatment planning for common mental health and/or substance use disorders
• Professional appearance and demeanor
• Proficiency in Windows applications, electronic medical record preferred
• Maintain confidentiality and HIPAA at all times

InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.