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Salary: USD 55,000 - 0 / annual
Ennoble Care is a mobile primary care, palliative care, and hospice service provider operating across 11 states (NY, NJ, MD, DC, VA, OK, KS, PA, TX, FL, GA). The company brings clinicians to patients' homes to provide continuity of care for those with chronic conditions and limited mobility, offering remote patient monitoring, behavioral health management, and chronic care management.
The BHI Specialist will support the mental and physical health care of an assigned patient caseload, primarily in the Northern Virginia area (Arlington, Manassas, Alexandria). This is a hybrid role that is primarily telephonic but includes occasional in-person visits to patient homes and facilities.
Key responsibilities include:
- Screen and assess patients for mental health and substance abuse disorders; facilitate patient engagement and follow-up care
- Provide patient education about mental health and substance abuse disorders and treatment options
- Monitor patients (in-person or by telephone) for changes in clinical symptoms, treatment side effects, and complications
- Support psychotropic medication management by consulting with behavioral health and primary care providers
- Deliver brief behavioral interventions using evidence-based techniques (behavioral activation, problem-solving treatment, motivational interviewing)
- Facilitate referrals to evidence-based psychosocial treatments as clinically indicated
- Participate in weekly caseload consultations with psychiatric consultants; communicate treatment recommendations to medical providers
- Track patient follow-up and clinical outcomes using a registry; document encounters in the EHR
- Document patient progress and treatment recommendations in EHR and other systems for sharing with the care team
- Facilitate treatment plan changes for patients not improving as expected
- Facilitate referrals for outside services (housing, vocational rehabilitation, specialty mental health care, substance abuse treatment)
- Develop relapse prevention and self-management plans with patients approaching discharge
- Manage daily productivity using Excel, Word, assessments, and productivity trackers
- Manage time effectively through calendars and EMR systems
Requirements:
- Minimum Master of Social Work (MSW) degree
- Preferred: licensure or provisional licensure as a social worker
- Behavioral health experience and knowledge
- Valid driver's license with insured, functioning automobile
- Ability to communicate effectively, both verbally and in writing
- Strong time management skills
- Comfort with both telephonic and in-person patient interactions
