Medical Case Manager, Immigrant and Refugee Health Center

Position: Medical Case Manager, Immigrant and Refugee Health Center

Department: General Internal Medicine

Location: Boston, MA

Schedule: 40 hours per week, On-site

ABOUT BMC

Boston Medical Center (BMC) is more than a hospital. It´s a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all—and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet – an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

POSITION SUMMARY

The Immigrant and Refugee Health Center (IRHC) Medical Case Manager is responsible for supporting patients of the IRHC, which includes patients seen in specialty programs including in the departments of Psychiatry (Boston Center for Refugee Health and Human Rights (BCRHHR)), General Internal Medicine (Immigrant and Refugee Health Program (IRHP)), OB/GYN (Refugee Women’s Health Clinic (RWHC)) and other collaborating departments throughout BMC.

The IRHC Case Manager will work to identify and engage patients in case management with a focus on patient experience and improving health from a biopsychosocial perspective. They will be responsible for conducting Needs Assessments/Intakes for new patients which includes comprehensive review of medical, mental health and social needs (legal, language, employment, transportation, etc.); for conducting mental health acuity assessments and triaging care appropriately; for serving as a member of the IRHC Mobile Response Team (which allows the IRHC to engage patients wherever they are across the hospital for support and connection to culturally responsive immigrant care); for providing case management services including working with patients to identify strengths and barriers and facilitating referrals to appropriate medical/clinical providers and social services and resources; and for creating a nurturing warm, welcoming environment for new patients.

The individual will comply with all data collection, data entry and data integrity needs both for facilitation of clinical care and reporting requirements to the BMC health system and funders. The individual will collaborate with clinical staff, administrative staff and research personnel in the IRHC and all of its specialty programs, and will partner closely with IRHC front desk staff to appropriately welcome, evaluate and triage patients.

Career development opportunities include participation in IRHC research and academic initiatives, participation in hospital-wide educational opportunities and providing teaching/trainings for hospital staff. Seeking someone with excellent interpersonal skills, critical thinking skills, and experience working with vulnerable immigrant and refugee populations, including those with trauma history and complex social and socioeconomic needs . Preference given to candidates who are bilingual and to those with connections to immigrant communities and lived experience as an immigrant to the United States.

JOB RESPONSIBILITIES

• Conducts Immigrant and Refugee Health Center (IRHC) Needs Assessment/Intake for new potential clients. Includes:

• Mental health acuity/crisis assessment, and facilitate appropriate triaging

• Comprehensive assessment of client’s medical, mental health and social needs

• Collection of funder-required data points

• Collaborate with front desk/administrative staff to schedule client for medical, mental health, social service appointments, as indicated by Needs Assessment

• Appropriate documentation of needs assessment data in EMR

• Support Walk-In clients, as well as provide case management for established IRHC clients

• Create a safe, warm, welcoming environment and encourage engagement in care

• Provide case management services for small caseload of established IRHC clients, including connecting patients to a broad range of services including but not limited to: mental health services, primary care services, medical specialty services, immigration legal services, financial assistance, food, transportation, housing, clothing, health literacy, interpreter service needs, etc.

• Provide client education regarding available services and resources both within the IRHC, throughout BMC and in community, and provide tools and facilitate connections to these resources

• Facilitates interdisciplinary consultation on patient’s behalf through participation in rounds, team meetings and clinical reviews

• Maintains HIPAA standards and confidentiality of protected health information.

• Performs and maintains all documentation in the electronic chart of patient encounters; resource development efforts; and other patient interventions and interactions

• Program development and administrative responsibilities include:

• Participates in multidisciplinary/staff/team meetings and activities; meets regularly with leaders at IRHC and specialty programs to triage program issues appropriately.

• Participates in team-based Quality Improvement (QI) initiatives

• Participates in local site operations, including team operational meetings; and is actively engaged in developing, implementing and refining operational protocols and processes as IRHC infrastructure expands

• Encouraged to engage in learning and growth opportunities including attending weekly Grand Rounds, and pursuing training opportunities with the approval of supervisor

• Adheres to departmental/organizational policies and procedures. Adaptable to changing programmatic needs

Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

EDUCATION

• Bachelor’s degree required.

• Master’s degree (or equivalent) in social work, psychology, or related human services field preferred.

• An equivalent combination of education and experience or specific certifications/licensures, which provides proficiency in the areas of responsibility, may be substituted for the education and experience requirements

CERTIFICATES, LICENSES, REGISTRATIONS

• LCSW, LICSW or LMHC as appropriate, preferred .

EXPERIENCE:

• 2-3 years of experience working in a medical or social services environment required .

• Experience with mental health populations preferred; demonstrated ability to evaluate and appropriately triage mental health crisis situations

• Experience with diverse immigrant and refugee populations preferred , including lived experience as immigrant to the United States.

• Experience and comfort with risk assessment and appropriate triaging required

• Experience in motivational interviewing is a plus

PREFERRED CERTIFICATES, LICENSES, REGISTRATIONS

• LCSW or LICSW preferred.

KNOWLEDGE AND SKILLS:

• Preference for candidates who are bilingual in English and Dari, Pashto, Haitian Creole, Spanish, Somali, Arabic, or French.

• Comfortable innovating in information technology systems; experience using/documenting in electronic medical record systems

• Excellent interpersonal skills and ability to work collaboratively

• Self-management skills, including ability to prioritize and set patient-centered goals. Knowledge of resources available to immigrant and refugee populations

• Excellent written and verbal communication

• Able to maintain professional boundaries

• Ability to work w