Make sure you get to meet everyone who is in a management position from the head of case management to the clinic medical director and clinic admin (CEO, etc). Ask the case managers how much pressure they get from non-clinical admin. Ask each ACT case manager how long they've worked on the ACT team or in community mental health case management. I worked at a community mental health clinic (while in residency training) where everyone was great to work with, but the CEO was a complete idiot. He was previously a manager at some sort of real estate company before taking over as head of a mental health clinic. So he knew nothing about providing health care. He was rude, dismissive, and would openly berate case managers in front of the team. This obviously made the place a terrible place to work, and ultimately the best case managers left for other jobs. This resulted in a lot of turnover, and the ACT team was staffed by a lot of fresh graduates...Which made me feel very exposed liability wise because as the ACT psychiatrist you really depend on the team. They also wouldn't let me schedule 30 minute follow up appointments, but basically forced everyone into 20 minute followup or 40 minute intakes. And there was nothing I could do as a resident. I raised my concerns with the residency director who eventually eliminated the rotation site. I would have quit this job after the first month if I was employed.
In an ideal world the ACT team would be made up of the best/senior case managers with years of experience but this is often not the case. I'd hope a majority of case managers have at least a few years of clinical case management experience, and hopefully their aren't MBA's telling you how to practice medicine. You also must have it in your contract how much time you have for followups and intakes. You don't want to be forced into 10 minute med checks. I would also want it in the contract that you have a say on hiring new case managers.
