Care Manager – Center of Excellence
The Opioid Center of Excellence (COE) is a community-based care management team. The team coordinates the care for the opioid population between systems creating a patient centered health home. The team creates warm hand offs between systems, coordinates transitions in care, assists with re-establishing life domains, incorporates medication assisted treatment, coordinates with primary care physicians, and creates rapid access to treatment.
Essential Job Responsibilities
- Take the role in providing admission, assessment, and level-of-care placements within the COE.
- Create, review, and monitor COE client profiles to ensure they represent the most
up-to- date information.
- Identify from assessments, the care management classification for the person served consisting of needing care management, complex care management, or transitional care management COE interventions.
- Identify COE persons served that have disconnected from recommended clinical care through electronic health record review with a minimum of a weekly review.
- Complete mobile assessments as requested that may be located at emergency rooms, medical offices, and the criminal justice system. Coordinate transportation needs to treatment facilities.
- Ensure warm handoffs with COE team and the Penn Foundation service delivery.
- Complete referrals and follow-up to all behavioral supports identified through assessment process (i.e. a person is COD and homeless; complete referral to recovery coaching, a person requires intensive support with vocational rehab.; complete referral to Reach and ensure connection). If a person served is non-COD, work with COE team to address needs (i.e. CRS may be identified to work with individual wanting to go back to school).
- Minimum Bachelor’s degree
- Displays sound theoretical knowledge of psychopathology, addiction, behavioral health, Pennsylvania Placement Criteria (PCPC 3rd Ed), the ASAM criteria, and knowledge of life domain needs assessment.
- A Pennsylvania Criminal Record Check, a Pennsylvania Child Abuse Clearance and a FBI Criminal History Background Check.
Penn Foundation is an equal opportunity employer