Job Details

Who we are: La Clinica de La Raza is a non-profit, community-based health center established in 1971 to address health barriers and create better lives for the underserved. We have proudly grown into 35 sites across Alameda, Contra Costa, and Solano County. To learn more about our history, click here: Our History - La Clinica or visit our website at www.laclinica.org.

Job Summary:

Under the supervision of the Clinical Supervisor, the Case Manager works actively to mitigate the social determinants of health that disproportionately impact our patient population. As an essential member of the care team, the Case Manager provides direct patient services within primary care or behavioral health clinics. The role of the Case Manager is to work closely with medical providers and behavioral health clinicians to provide access, coordination, and care management for La Clínica patients who have medical, psychosocial and/or behavioral health care needs. This role requires the ability to develop strong relationships with at-risk patients (and families), to support our patients in accessing culturally appropriate psychosocial, medical, and behavioral health services. This position requires the ability to provide linkage and referral, patient education, advocacy, motivational interviewing, and emotional support.

The Case Manager role is most suited for someone seeking to advance their career in behavioral health or related social service, and that has had experience in a medical, social service or behavioral health setting, ideally providing case management, counseling, or crisis intervention). La Clinica supports and encourages continued education, training, and career advancement.

Major Areas of Responsibility, include but are not limited to:

Duties/Responsibilities:

• Conducts strength-based psychosocial assessments addressing wide range of presenting behavioral health and psychosocial issues or needs; provides patient and resource information to medical providers or behavioral health clinicians; develops a follow-up plan.
• May provide evidence-based, short-term psychosocial counseling/and or rehabilitation counseling and psychoeducation to clients and their families. Involves family members/significant others as necessary to increase client participation and improve patient well-being.
• Provides crisis intervention as needed.
• Provides education, information, and referral to La Clinica patients to ensure linkage and utilization of care within La Clinica and external community services and resources.
• Identifies high-risk patients and refers and consults with supervisors as appropriate.
• Runs psychoeducational or resource groups or assists with psychotherapy groups as indicated by clinical needs of patient population and grant deliverables.
• Administers objective screening tools and outcome measures as determined by program.
• Conducts and facilitates timely and coordinated internal communications among patients, medical providers, behavioral health staff, consulting/treating psychiatrists and others involved in the patient's care provision.
• Develops and maintains a comprehensive referral system to link patients to resources.
• Links patients effectively and efficiently to all levels of assessment and resources within and external to La Clinica and monitors linkage to resources and patient participation in primary care and behavioral health care.
• Provides outreach, advocacy, and follow-up through phone calls and meetings, to support successful patient access to services and resources and engagement in care.
• Acts as a single point of contact to receive and coordinate referrals.
• Receives and facilitates warm hand-offs and referrals between medical, behavioral health staff and community resources to support whole person health.
• Uses Electronic Health Record (EHR) and population management tools to collect data, communicate with medical and behavioral health providers and produce reports to support collaborative care, improved health outcomes and program compliance.
• Participate in case presentations, seminars, regular clinical supervision with supervisor and peer review as needed.

The following applies when working within the scope of:

In Comprehensive Perinatal Services Programs (CPSP) only:

• Conducts routine assessments of pregnant patients, identifies strengths, and risks, and develops a service plan in accordance with CPSP protocols and procedures.

In Specialty Mental Health programs only:

• Works with clinical team to support clients with severe and persistent mental illness in achieving wellness and recovery.
• Accompanies clients to appointments to ensure adherence to treatment plan.
• Provides individual rehabilitation and coaching services in the community.
• Provides supportive case management services to complement clinical treatment goals.
• Possession of a valid driver's license and reliable transportation.

In School-Based Health Center (SBHC) programs:

• Conducts needs assessments for Newcomer students to assess need for linkage to community services, insurance and school support.
• Supports school advocacy related to IEP/504 processes.
• May require registration as Wellness Coach with the state of CA.

In Pediatric settings:

• Provides screening using specific pediatric tools.
• Coordinates referrals to Regional Center and for services related to autism such as ABA.

Minimum Job Requirements:

Knowledge, Skills, and Abilities:

• Cultural competence and proactive self-reflection on positionality and incorporation of antiracism approaches to clinical care.
• Knowledgeable in the principles, practices, and techniques of social work; basic psychological theory and practices related to human behavior.
• Familiarity with local resources and regulations (i.e., behavioral health care setting)
• Experience with modalities of brief counseling. Familiarity with Cognitive-Behavioral Therapy, Solution Focused Counseling and Motivational Interview preferred. Ability to establish rapport and conduct a psychosocial assessment with sensitive questions to assess patient needs and strengths and gather relevant information.
• Ability to quickly identify risk factors as they relate to patient safety and communicate these immediately and effectively to appropriate team members.
• Ability to form empathic and collaborative relationships with patients with medical and behavioral health challenges and flexibility in meeting patients' needs.
• Excellent organizational skills and a high degree of interpersonal competence with both staff and patients.
• Ability to work under the direction of clinicians and medical providers.
• Ability to work in a fast-paced environment as part of an interdisciplinary team.

Education and Experience:

• Must have Associates Degree (AA) in a social services or behavioral health program (AA degree is required for Specialty Mental Health settings).
• Must hold a current BLS (Basic Life Support) Certificate. You will have 30-day grace period to obtain your certificate from the date of hire.
• Must have experience resulting in familiarity and comfort working with individuals impacted by psychosocial stressors and/or behavioral health conditions.
• Must have one year experience providing coordination, advocacy, with direct involvement in team providing services including crisis intervention (as described below) or case management experience in a behavioral health/medical/social service setting.
  • Crisis intervention experience includes working with Domestic Violence, warmline/hotline response, substance abuse, depression, anxiety, poverty, homelessness, disability, complex medical conditions and/or other psychosocial stressors.
• English/Spanish preferred; may be required depending on location.

In some Behavioral Health programs, the Associate's degree may be substituted with:

• High School Diploma/GED, and 2 years of relevant work experience.

Physical Requirements:

• Remaining in a stationary position, often standing, or sitting for prolonged periods
• Bending/lifting, pushing/pulling, adjusting, or moving objects weighing up to 15 pounds in all directions and occasionally more.
• Repeating motions that may include the neck, wrists, hands and/or fingers.
• Upper extremity demands: Reaching above shoulder and/or below waist.