Professional I, Behavioral Health Specialist

Essential Duties and Responsibilities:

Engagement, Assessment, and Client Support
Explain the purpose, expectations, and process of case management services to clients and support informed participation in services.
Obtain relevant information from clients and collateral sources to assess strengths, needs, preferences, safety, well-being, activities of daily living, instrumental activities of daily living, and immediate service needs.
Administer appropriate screening and assessment tools to support shared decision-making, goal setting, and individualized service planning.
Establish and maintain positive, therapeutic relationships with clients through face-to-face, telephonic, office-based, property-based, and community-based engagement.
Engage clients through assertive outreach to identify wellness needs, service preferences, barriers, and opportunities for support.
Support clients in developing independent living skills, including budgeting, paying bills, understanding leases, and maintaining housing stability.
Service Planning, Case Management, and Housing Stability
Review assessment and screening outcomes with clients to prioritize needs and develop immediate, short-term, and long-term service goals.
Develop and maintain individualized service plans and housing success plans that reflect client strengths, needs, measurable goals, timeframes, and case management strategies.
Provide individualized case management, care coordination, and Therapeutic Behavioral Services in settings that meet the needs of the client.
Provide behavioral health interventions based on client presentation, assessed needs, preferences, medical necessity, and applicable evidence-based practices.
Apply Housing First, Harm Reduction, Motivational Interviewing, Stages of Change, Stage-Wise Interventions, and other evidence-based approaches to support wellness and housing stability.
Provide ongoing pro-social support and life skills training on an individual and group basis to promote independence, wellness, and housing retention.
Conduct ongoing monitoring to assess progress, evaluate the effectiveness of service plan strategies, and adjust interventions as needed.
Appropriately transition or terminate case management services, including providing reasonable notice and supporting continuity of care when applicable.
Coordination, Linkage, and Monitoring
Work collaboratively with the multidisciplinary service team, including counselors, nurses, physicians, pharmacists, social service staff, Property Management, and the PSH Care Team to support positive client outcomes.
Identify, maintain, and use knowledge of community resources to connect clients with supports related to housing, neighborhood and environmental needs, social supports, peer and community needs, economic needs, education, vocational goals, and other social determinants of health.
Make formal and informal referrals to service providers identified in the case management plan and follow up to address barriers to care, resources, and services.
Support clients following hospitalization or other transitions in care to promote community functioning and reduce avoidable emergency room or hospital utilization when possible.
Assist clients with linkage to primary care, behavioral health, substance use, and other needed services, including attending appointments, transporting or accompanying clients, and addressing transportation barriers as needed.
Identify and address barriers to medication adherence, medical appointments, behavioral health appointments, benefit access, and service engagement.
Assist clients with benefit applications, renewals, advocacy, and appeal processes as needed.
Participate in multidisciplinary team meetings, Property Management meetings, PSH Team meetings, PSH application interviews, move-in activities, routine housing inspections, and move-out planning.
Facilitate team-based care by supporting communication among clients, healthcare teams, service providers, property management, and client support networks.
Develop and participate in community-building activities in collaboration with the PSH Care Team, which may include tenant associations, orientation supports, newsletters, welcoming activities, support groups, or other social and community-oriented programming.
Clinical Proficiency, Documentation, and Compliance
Recognize common behavioral health, physical health, and substance misuse conditions and symptoms, and apply prevention measures to mitigate potential behavioral health crises.
Understand and apply risk assessment practices, including crisis and lethality assessment, and use clinical supervision appropriately.
Use the organization’s electronic medical record system to document case management service activity, progress, outcomes, consents, and related information in a clear, concise, objective, professional, and timely manner.
Ensure documentation clearly links services provided to the client’s service plan, goals, progress, and outcomes.
Protect client privacy and confidentiality in accordance with applicable laws, regulations, organizational policies, and best practices, including obtaining or confirming appropriate releases before sharing client information.
Ensure required consents to services are completed, signed, dated, and on file before providing treatment or services.
Follow applicable professional codes of ethics, standards of practice, federal and state requirements, and organizational policies to protect client rights and promote quality care.
Prepare reports and utilize available data to support positive client health outcomes and program needs.
Site and Program Support
Support onsite food pantry operations approximately once per month, including inventory, shopping, pickup and/or coordination of delivery, and related duties as assigned.
Obtain and maintain required food safety certification, as applicable and provided through The Centers.
Maintain supply inventory at assigned site.
Other Non-Essential Duties and Responsibilities:

Perform other related duties as assigned.
Qualifications:

Education:

High school diploma or equivalent
Bachelor’s degree in Social Work, Psychology, or a mental health-related field preferred. If degree is in a related field, two years of care coordination or case management experience is preferred.
Licensure/Certification:

Valid Ohio driver’s license and access to an insured vehicle required for client transportation and community-based services.
Nonviolent Crisis Intervention certification required within 60 days of hire.
Active Community Health Worker certification preferred.

Experience:

At least three years of case management or care coordination experience required.
Prior experience working with adults with serious and persistent mental illness preferred.
Skills:

Ability to work collaboratively and effectively as part of a multidisciplinary team.
Ability to develop effective therapeutic relationships and engage clients in assessment, goal setting, service planning, and ongoing care coordination.
Ability to identify needs, problem-solve barriers, and connect clients to appropriate community resources and supports.
Working knowledge of behavioral health, substance use, trauma-informed care, stages of change, harm reduction, and housing stability practices.
Ability to understand and support the agency’s team-based service delivery model, program philosophy, and client-centered approach.