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Behavioral Health Care Manager (Social Worker)
US-OR-Portland
Family Medicine at South Waterfront is a community‑based clinic offering primary care and specialty services for all types of patients. We treat everyone—babies, children, adolescents, adults (including moms‑to‑be), and seniors. Our services include prenatal care (including deliveries), women’s reproductive health, behavioral health care and counseling, transgender care, pediatric care, travel immunizations, podiatry and foot care clinics, sports medicine, Osteopathic Manipulative Treatment (OMT), Office Based Medication Assisted treatment (OBAT), acupuncture, minor procedures, and health maintenance with preventive care. Between 175 and 275 patients are seen daily by our 40 plus providers assisted by 60 plus staff members.
Function/Duties of Position Counseling
Provide brief behavioral interventions using evidence‑based techniques such as behavioral activation, problem‑solving treatment, motivational interviewing, or other treatments as appropriate.
Integrate trauma‑informed and trauma‑focused therapies (e.g., EMDR, TF‑CBT, or other validated modalities) when clinically indicated to address the impact of trauma on patient health and functioning.
Support the patient in their psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
Provide or facilitate in‑clinic or outside referrals to evidence‑based psychosocial treatments (e.g., problem‑solving treatment or behavioral activation) as clinically indicated.
Support the mental and associated physical health care needs of patients on an assigned patient caseload. Closely coordinate care with the patient’s continuity medical provider and, when appropriate, other mental health providers.
Patient Services
Systematically track treatment response and monitor patients (in person or by telephone or virtual visit) for changes in clinical symptoms and treatment side effects or complications.
Manage collaborative care registry.
Facilitate referrals for clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).
Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant and who may need more intensive or more specialized mental health care.
Documentation
Document patient progress and treatment recommendations in the electronic health record (EHR) and other required systems to be shared with medical providers, psychiatric consultant, and other treating providers.
Track patient follow up and clinical outcomes using a registry. Document in‑person and telehealth encounters in the registry and use the system to identify and re‑engage patients.
Develop and complete relapse prevention self‑management plan with patients who have achieved their treatment goals and are soon to be discharged from the caseload.
Other duties as assigned.
Required Qualifications
A Master’s Social Work (MSW) required. Health care experience preferred.
Certificate of Clinical Social Work Associate (CSWA) or Licensed Clinical Social Worker (LCSW) required for employees who practice clinical social work.
Preferred Qualifications
Training in Primary Care Behavioral Health
Health care experience
Experience in behavioral health counseling and brief short‑term therapy strategies and case management in an ambulatory setting.
Experience and/or interest in Collaborative Care.
Experience in a Primary Care Ambulatory Clinic setting.
Experience with program development and evaluation.
3 years’ experience in a similar position.
Additional Details Hours: Variable. Five 8‑hour shifts, Monday‑Friday, with possibility of evening or weekend hours. Flexing start/end times to accommodate clinical needs may be provided.
The work is performed in a medical setting and involves normal working hours with occasional alternative hours for special programs or outreach. The position involves interactions with people who have a wide variety of physical and behavioral health problems. Some travel may be required.
Posted 12/3/2025 4:01pm
All are welcome. Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply.
To request reasonable accommodation contact the
Affirmative Action and Equal Opportunity Department
at 503‑494‑5148 or aaeo@ohsu.edu.
#J-18808-Ljbffr
Family Medicine at South Waterfront is a community‑based clinic offering primary care and specialty services for all types of patients. We treat everyone—babies, children, adolescents, adults (including moms‑to‑be), and seniors. Our services include prenatal care (including deliveries), women’s reproductive health, behavioral health care and counseling, transgender care, pediatric care, travel immunizations, podiatry and foot care clinics, sports medicine, Osteopathic Manipulative Treatment (OMT), Office Based Medication Assisted treatment (OBAT), acupuncture, minor procedures, and health maintenance with preventive care. Between 175 and 275 patients are seen daily by our 40 plus providers assisted by 60 plus staff members.
Function/Duties of Position Counseling
Provide brief behavioral interventions using evidence‑based techniques such as behavioral activation, problem‑solving treatment, motivational interviewing, or other treatments as appropriate.
Integrate trauma‑informed and trauma‑focused therapies (e.g., EMDR, TF‑CBT, or other validated modalities) when clinically indicated to address the impact of trauma on patient health and functioning.
Support the patient in their psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
Provide or facilitate in‑clinic or outside referrals to evidence‑based psychosocial treatments (e.g., problem‑solving treatment or behavioral activation) as clinically indicated.
Support the mental and associated physical health care needs of patients on an assigned patient caseload. Closely coordinate care with the patient’s continuity medical provider and, when appropriate, other mental health providers.
Patient Services
Systematically track treatment response and monitor patients (in person or by telephone or virtual visit) for changes in clinical symptoms and treatment side effects or complications.
Manage collaborative care registry.
Facilitate referrals for clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).
Facilitate treatment plan changes for patients who are not improving as expected in consultation with the medical provider and the psychiatric consultant and who may need more intensive or more specialized mental health care.
Documentation
Document patient progress and treatment recommendations in the electronic health record (EHR) and other required systems to be shared with medical providers, psychiatric consultant, and other treating providers.
Track patient follow up and clinical outcomes using a registry. Document in‑person and telehealth encounters in the registry and use the system to identify and re‑engage patients.
Develop and complete relapse prevention self‑management plan with patients who have achieved their treatment goals and are soon to be discharged from the caseload.
Other duties as assigned.
Required Qualifications
A Master’s Social Work (MSW) required. Health care experience preferred.
Certificate of Clinical Social Work Associate (CSWA) or Licensed Clinical Social Worker (LCSW) required for employees who practice clinical social work.
Preferred Qualifications
Training in Primary Care Behavioral Health
Health care experience
Experience in behavioral health counseling and brief short‑term therapy strategies and case management in an ambulatory setting.
Experience and/or interest in Collaborative Care.
Experience in a Primary Care Ambulatory Clinic setting.
Experience with program development and evaluation.
3 years’ experience in a similar position.
Additional Details Hours: Variable. Five 8‑hour shifts, Monday‑Friday, with possibility of evening or weekend hours. Flexing start/end times to accommodate clinical needs may be provided.
The work is performed in a medical setting and involves normal working hours with occasional alternative hours for special programs or outreach. The position involves interactions with people who have a wide variety of physical and behavioral health problems. Some travel may be required.
Posted 12/3/2025 4:01pm
All are welcome. Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply.
To request reasonable accommodation contact the
Affirmative Action and Equal Opportunity Department
at 503‑494‑5148 or aaeo@ohsu.edu.
#J-18808-Ljbffr