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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 engagement and follow-up care
- Provide patient education on mental health and substance abuse disorders and treatment options
- Monitor patients (in-person or by telephone) for clinical symptom changes, treatment side effects, and complications
- Support psychotropic medication management by consulting with behavioral health and primary care providers
- Deliver brief evidence-based behavioral interventions (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 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 systems for sharing with the care team
- Facilitate treatment plan changes for patients not improving as expected
- Facilitate referrals for specialized services (mental health specialty care, substance abuse treatment, social services)
- Develop relapse prevention and self-management plans for patients being discharged
- Manage daily productivity using Excel, Word, assessments, and EHR systems
- Demonstrate strong time-management and organizational skills
Requirements:
- Minimum Master of Social Work (MSW) degree
- Preferred: Licensed or provisionally licensed social worker
- Behavioral health experience and knowledge
- Valid driver's license with insured, functioning automobile
- Effective verbal and written communication skills
- Strong time management abilities
- Comfort with both telephonic and in-person patient interactions
