Case Manager - MHA/PASRR

Gulf Coast Center

Brazoria, TX, USA

Full time

Healthcare / Community Health & Mental Health

Sep 1

This job is no longer accepting applications.

Provides specialized services and service coordination for individuals with Mental Illness (MI), Intellectual Disabilities (ID), Developmental Disabilities (DD) or Related Conditions (RC) to ensure they are placed appropriately, whether in the community or in a Nursing Facility: and to ensure they receive the services that they require for their MI or IDD/DD. The PASRR Case Manager (CM) offers specialized services to help the individual achieve and maintain community reintegration skills. The position provides or arranges for provision of educational or informational activities addressing community living options for individuals transitioning from nursing facilities and their families. The PASRR CM, QMHP will complete case management assessment on clients entering caseload that live in Brazoria County with an MI diagnosis and develop appropriate treatment/service plans with clients as the means for implementing appropriate services and developing effective rapport with clients.  The PASRR CM, QMHP will provide on-going case management functions in accordance with the problems, needs, and the strategies identified within the service plan in order to help the clients to achieve goals and objectives and provide face to face assessments with the clients on a biannual basis. The PASRR MH, QMHP may provide coverage to individuals residing in Galveston County as needed. For individuals with MH, responsibilities include assisting individuals, families and care providers in developing individual recovery plans and TRR Services for the caseload. The Case Manager assists individuals and their families in identifying goals, identifying and advocating for resources/services, coordinating for the delivery of services, monitoring the progress of the plan and assisting with crisis prevention management. Accurate documentation and billing of these services are required. 

Gulf Coast Center operates under a trauma-informed approach based on the six key principles of Safety, Trustworthiness & Transparency, Peer Support, Collaboration & Mutuality, Empowerment & Choice, and Cultural, Historical & Gender issues.

Job Duties: (To be performed with or without accommodation as based on ADA requirements)

The Case Manager - MHA/PASRR will be responsible for the following:

Essential Job Duties:

  • Person Centered Recovery Planning (PCRP): Coordinates the service planning team for the development of the PCRP through a person centered process that identifies strengths, preferences, medical, nursing, nutritional, clinical and support needs of the individual and the desired outcomes. 
  • Monitoring: Continual monitoring of all relevant standards for compliance (HHSC, TAC, etc). Monitoring of the individual's progress in relation to the PCRP. Frequency of face to face monitoring is determined by the service coordination assessment tool and the needs of the individuals served and should be at a minimum, every 90 days. Maintaining contact with all of the relevant individuals as determined by the PCRP and communicating with the individual or family regarding progress and/or changing needs. Maintaining close communication with facility psychiatric services (where applicable) and nursing, for input regarding medication compliance, side effects of medication, and medication changes and alerts these members of the staff of any changes in client adjustment which might suggest decomposition and a need for more aggressive intervention.
  • Rehabilitative Treatment Provider: Provides RCM self management strategies and clinical coordination to individuals, groups, and family members as defined by GCC using evidence based strategies within the (TRR) model of care. Provides monthly documented face to face hours of direct service per month to GCC consumers and/or family members as indicated in the current Direct Service Agreement for this position. Monitors patients' requirements within the TRR model to ensure required services are offered and meeting targeted monthly service provision standard for identified caseload. Assure treatment provided to patient relates to the individualized goals of treatment plan. Utilizes a variety of skills training methods to include areas such as introduction, role play, behavioral reversal, in-vivo practice, and coaching.
  • Billing/Documentation: Accurately completes all required programmatic and administrative documentation within accepted timeframes. Ensures all required documentation has been forwarded to appropriate personnel and filed. Conducts the Adult Needs & Strengths Assessment (ANSA) every 6 months or as clinically indicated for individuals as required & assigned. Responsible for ensuring staff completion of initial & annual ANSA recertification pursuant to the Praed Foundation & HHSC performance contract. A lapse/expiration in certification will result in termination of employment. Exception: If certification lapse/expiration is reported to supervisor within 24 hours of expiration date, employee will be granted opportunity to recertify by close of following business day. Any lapse/expiration greater than 24 hours will result in termination of employment. Additionally, all certified practitioners are responsible for participating in semi-annual quality assurance training activity conducted by the identified ANSA/CANS Super User.
  • Strict adherence to authorizations and to all GCC policy guidelines outlined in GCC medication transport guidance letter when there is a need to transport patient medications. 
  • Will be responsible and accountable for the adherence to and promotion of the agency compliance policy and will require communication with various departments to foster, develop and continue our community partnerships as it relates to the position.
  • Treat all individuals with the utmost courtesy, decency and respect.
  • Provide responsive, and efficient services.
  • Interact with staff, consumers, local entities and advocacy groups to provide a service that meets local needs.
  • Provide highest level of Customer Service for both internal and external customers.
  • Required to report personnel leave; flex time and emergency leave to assigned supervisor.
  • Strict adherence to the professional, ethical, and legal requirements set forth in GCC's Business Code of Conduct as well as the Corporate Compliance Plan.
  • Consistent adherence to the Center's Dress Code.
  • Consistent adherence to Center safety guidelines and expectations.
  • May be required to travel within Brazoria and Galveston Counties.
  • Out of region travel may be required to attend trainings.
  • Must maintain a clear driving record and driver's license in accordance with our Driver Policy.
  • Requires current Texas Driver's License, reliable transportation and must maintain current auto liability insurance.

Non-Essential Job Duties:

  • N/A


  • Receives direct supervision from Program Manager-MCSC and oversight by IDD Intake & PASRR Program Manager 

Required Education:

  • Bachelor's degree from an accredited college or university with a major in social, behavioral, health or human services and/or specialized QMHP certification.

Preferred Education/Licensure/Certifications:

  • N/A

Required Licensure/Certifications:

  • N/A

Required Experience:

  • One year of experience working with individuals with Mental Illness is required. 
  • General knowledge of IDD and MI services and resources

Preferred Experience:

  • One year of experience working with individuals with intellectual or developmental disabilities preferred. 
  • Two to three years full-time experience in human services preferred. 


  • Ability to express self clearly and effectively, orally and in writing.
  • Requires ability to work within a team approach.
  • Requires proficiency with computer skills, programs and email.

Working Conditions:

  • Work will be performed in the Office, Field and/or Remotely setting(s).
  • May require varied work hours depending on need of clients.
  • Out of region travel may be required to attend trainings.
  • May require travel to various locations within Brazoria and Galveston Counties. Requires current Texas Driver's License, reliable transportation safe and current with all state requirements, and liability insurance.
  • The work environment is mostly field based (nursing facilities and home visits) and also requires some office work. 

Special Projects:

  • Assist supervisor when requested to complete special projects and complete all assignments within a time frame negotiated with the supervisor. Completion of other duties as assigned by supervisor as it relates to the program and position.

Job Related Physical/Mental Requirements & Environmental Conditions:


  • Ability to transport, adjust and/or move items up to 55 lbs.
  • Ability to ascend/descend stairs.
  • Ability to remain in a stationary position for long periods of time.
  • Ability to handle objects.
  • Ability to operate office equipment.
  • Ability to move around within an office setting and/or other locations as needed; may include ability to bend/twist, kneel/stoop and/or reach for items.
  • Ability to push/pull, crawl/squat as it relates to PMAB requirements; may be required to perform PMAB restraints as it relates to program requirements.
  • Ability to detect and write effectively.
  • Ability to hear (with or without aid).
  • Ability to have visual acuity to operate a motor vehicle and observe objects within work setting.


  • Ability to accept constructive criticism.
  • Ability to maintain regular attendance.
  • Ability to understand, communicate and comprehend accurate information with others in English.
  • Ability to reason and analyze effectively.
  • Ability to solve practical problems as it relates to position.
  • Required to pass and maintain all Center mandated trainings.

Work Site/Environmental Conditions:

  • Ability to work alone.
  • Ability to work closely with others.
  • Ability to work closely with clients and/or family members with poor hygiene. Ability to work long and/or irregular hours.
  • May be subjected to hostile environment.
  • May be subjected to high crime environment.
  • Potential exposure to tobacco products.
  • May be subjected to both inside and outside environmental conditions.
  • Subject to standard noise levels within working environment.
  • Travel by motor vehicle, van, bus or plane may be required.

Qualified individuals must be able to perform these functions with or without reasonable accommodations as based on ADA requirements.

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Gulf Coast Center

Better community healthcare promoting healthy living