Follow-Up Specialist II - Mobile Crisis Team KY

• Carry moderate-risk post-crisis caseloads referred from 988, E/inpatient discharge, Mobile Crisis, SUD crisis/overdose risk, PSAP diversion, and other community stakeholders, as assigned.
• Initiate follow-up within 24 hours; document verbal/written consent; provide 90-day to 12-month structured follow-up.
• Engage individuals using trauma-informed, recovery-oriented, person-centered, and culturally responsive approaches.
• Implement Caring Contacts: iCare postcards, structured phone/text outreach, and low-demand check-ins.
• Assess follow-up needs and identify barriers that may interfere with successful connection to recommended behavioral health, substance use, medical, or community-based services.
• Assist individuals in understanding recommended services, available resources, treatment options, and next steps following a crisis episode.
• Facilitate connections and referrals to appropriate services, including outpatient behavioral health care, substance use treatment, medical services, peer support, and community-based resources.
• Provide appointment navigation, including assisting individuals with identifying appropriate providers, understanding referral requirements, coordinating appointments, and addressing barriers to attendance.
• Facilitate warm handoffs to behavioral health providers, healthcare organizations, peer support services, and other community partners to strengthen continuity of care.
• Coordinate with peer support specialists when peer-based engagement, recovery support, or service navigation would benefit the individual.
• Support transitions of care and work to reduce gaps in services that may contribute to repeated crisis episodes or unnecessary use of higher levels of care.
• Collaborate with crisis clinicians and other members of the interdisciplinary team regarding identified needs, risk and safety considerations, social determinants of health, service connections, and follow-up activities.
• Work collaboratively with behavioral health providers, medical providers, emergency departments, community organizations, and other partners to coordinate services.
• Serve as a liaison between individuals, families or natural supports when appropriate, providers, and community resources to facilitate successful service connection.
• Advocate for individual needs while promoting self-determination, dignity, empowerment, and appropriate professional boundaries.
• Maintain timely, accurate, and compliant documentation and data of outreach attempts, contacts, referrals, risk assessments and reassessments, service connections, warm handoffs, and follow-up outcomes in the electronic health record and other required systems per MOU and privacy requirements.
• Maintain effective communication with Crisis Services team members regarding follow-up status, barriers to care, service connections, and other relevant information.
• Adhere to agency policies, applicable licensing requirements, professional and ethical standards, HIPAA requirements, and applicable state and federal regulations.
• Participate in team meetings, trainings, case consultation, and quality-improvement activities related to crisis follow-up and continuity of care.
• Maintain knowledge of behavioral health, substance use, healthcare, peer support, and community resources available to individuals served by Crisis Services.
• Assist with Mobile Crisis Service delivery as needed and available.
• Perform additional responsibilities as needed to support Crisis Services program operations.

Why Choose RiverValley?

RiverValley is now a Certified Community Behavioral Health Clinic (CCBHC), expanding access to high-quality, integrated care in the communities we serve. Join a mission-driven organization committed to clinical excellence, professional growth, and meaningful impact.

We offer:

• Competitive pay

• Comprehensive benefits (health, dental, vision, Telehealth)

• Paid time off 9 holidays

• Retirement plan options

• Tuition reimbursement free CEUs

• Clinical supervision

• Wellness & employee assistance programs

• Mileage reimbursement for work related travel

• Public Service Loan Forgiveness (PSLF) - eligible employer

• Bachelor's degree in social work, psychology, or a related behavioral health field

• Knowledge of mental health and substance use disorders, crisis services, harm reduction, and recovery-oriented approaches.
• Knowledge of community resources, behavioral health services, social service systems, and healthcare navigation.
• Ability to engage individuals following a crisis and establish rapport using person-centered, trauma-informed approaches.
• Ability to recognize barriers to treatment engagement and assist individuals in navigating services and resources.
• Ability to coordinate referrals, appointments, peer services, and warm handoffs across systems of care.
• Strong communication and interpersonal skills with the ability to collaborate effectively with individuals, families, providers, and community partners.
• Strong organizational, time-management, follow-through, and problem-solving skills.
• Ability to manage multiple follow-up contacts and priorities while completing required activities within established timeframes.
• Cultural humility and the ability to provide respectful services to individuals from diverse identities, backgrounds, and life experiences.
• Ability to maintain appropriate professional boundaries, confidentiality, and ethical standards.
• Proficiency with documentation, electronic health records, and coordinated communication across providers and systems.
• Valid driver's license.