Primary Job Functions:
Clinical Responsibilities:
- Provides effective clinical assessment of the consumer at intake and continuously thereafter.
- Utilizes assessment data to support a DSM – 5 TR diagnoses; updates diagnose as needed.
- Formulates a person centered, recover oriented, medically appropriate treatment plan along with consumer that proves medical necessity and obtains signatures each time the plan created, updated and/or revised.
- Enters medications into Pre entry medications for Infoscriber upon intake and as needed.
- Completed CANS in accordance with standards.
- Provides individual, group, and family therapy, utilizing evidenced based and research-based models and theories according to consumer needs as stated in the treatment plan.
- Provides referrals when needed to internal and external agencies.
- Demonstrates the ability to recognize the elements of a crisis state and knows how to deescalate or resolve the situation.
- Effectively collaborates with the treatment team members and outside sources in the delivery of clinical services.
- Evaluates the consumer for discharge planning – provides appropriate referrals and/or linkage and closes chart appropriately.
- Effectively demonstrates the application of adult specific competencies.
- Adheres to professional code of ethics.
- Approves treatment plans that meet the requirements of AltaPointe, Medicaid, Joint Commission, and State Department of Mental Health in a timely manner.
- Completes treatment plan reviews as assigned in a timely manner and in accordance with Medicaid and the Alabama Department of Mental Health standards; provides justification for overdue reviews.
- Reviews API and signs off at the end of each time period according to standards.
- Obtains CEU’s in accordance with Alabama DMH standards for working with the child and adolescent population.
Supervision and Consultation:
- Seeks clinical supervision and consultation as needed.
- Accepts and employs suggestions for improvement.
- Actively works to enhance clinical skills.
Clinical Record Keeping:
- Documents in a timely fashion per AltaPointe policy
- Documents appropriate, complete, and clinically comprehensive mental health assessments – including diagnostic impression and referrals.
- Documents measurable and specific problem statements, goals, and objectives in the treatment plan
- Documents in a clear and concise manner treatment goals and objectives addressed, interventions provided, techniques used, consumer progress and response in direct service record.
- Documents case disposition, case closings, follow-up, and referrals
- Documents legibly and includes credentials with all signatures.
Case Load Management:
- Effectively manages caseload based on consumer needs.
- Meets AltaPointe productivity standards.
Courteous and respectful attitudes towards consumers, visitors, and co-workers
- Treats consumers with care, dignity, and compassion
- Respects consumers privacy and confidentiality
- Is pleasant and cooperative with others.
- Assists visitors and consumers as needed.
- Personal values do not inhibit ability to relate and care for others.
- Is sensitive to the consumers needs, expectations and individual differences.
- Is gentle and calm with consumers and families.
Administrative and Other Related Duties as Assigned:
- Actively participates in Performance Improvement activities.
- Actively participates in AltaPointe committees as required.
- Completes assigned tasks in a timely manner.
- Accesses appropriate community resources according to consumer needs
- Follows AltaPointe policies and procedures.
- Maintains current license and requirements for renewals (i.e., CEU’s), if applicable, and attends to required in-services and workshops.
- Attends scheduled outpatient educational groups for therapists regularly.