Primary Purpose of the Organization:

The primary purpose of PORT Health Services is to provide or arrange access to a full continuum of care for individuals with intellectual/developmental disabilities, substance abuse, mental health and psychiatric disorders. The continuum of care provides a wide array of services, which includes prevention, outpatient, residential, and transitional programs for adults, adolescents and family members. More specifically services include but are not limited to screenings, evaluations and assessments, habilitative supports and therapies, case management, emergency interventions, day treatment, medical detoxification, medication management, referrals and education.

Work Schedule

This position will maintain an average work schedule of 40 hours per week for full-time employment, and up to 24-hours-per-week for part-time employment. Generally, working the hours between 8:00am-9:00pm, but flexibility will be expected depending on client and Program’s need.

Change in Responsibilities or Organizational Relationship: This is a new position created for the Tailored Care Plan.

A. DESCRIPTION AND RESPONSIBILITIES OF DUTIES

• Performing general outreach, engagement, and follow-up with members;
• Coordinating services/appointments (e.g., appointment/wellness reminders, arranging transportation);
• Engaging in health promotion activities (as defined in the Tailored Care Management Provider Manual) and knowledge sharing;
• Sharing information with the care manager and other members of the care team on the member’s circumstances;
• Providing and tracking referrals and providing information and assistance in obtaining and maintaining community-based resources and social support services;
• Participating in case conferences;
• Support the care manager in assessing and addressing unmet health-related resource needs.

A care manager should directly supervise extenders and ensure that they are only performing functions within their training, scope, and abilities, given that some extenders will have limited experience working with individuals with significant behavioral health, I/DD, and TBI needs. Supervising care managers, care managers, and extenders should be in regular communication and coordinate their efforts to mitigate duplicative or inappropriate outreach to assigned members.

KNOWLEDGE, SKILLS, ABILITIES, TRAINING/EXPERIENCE REQUIRED

To ensure that extenders are prepared to support Tailored Plan members, all extenders will complete the full Tailored Care Management training curriculum before being deployed to serve members and must complete the remaining training modules within 30 days of being deployed to serve members.

Minimum Requirements

• Is at least 18 years of age;
• Has a high school diploma or equivalent;
• Is trained in Tailored Care Management;
• Is supervised by a care manager at an AMH+ practice, CMA, or Tailored Plan, and meets one of the below requirements: