How to Choose the Next Hire for an Integrated Care Team

Find the work that is not getting done

Ask where patients wait, where referrals stall, which follow-ups are missed, what responsibilities remain with a clinician who has no capacity, and which tasks are being handed between teams without a clear owner. Use examples from the actual workflow rather than a general statement such as needing more behavioral-health support.

AHRQ’s shared-care-plan guidance describes coordination among primary-care providers, mental-health providers, substance-use counselors, and other team members. For hiring, the practical lesson is to name the work at those boundaries: what gets referred, who follows up, how updates reach the team, and where the patient’s priorities enter the plan.

• AHRQ: Develop a shared care plan

Match the discipline to the role

A PMHNP, psychiatrist, or psychiatric PA may be relevant when the need is psychiatric evaluation or prescribing within the applicable scope. A therapist, clinical social worker, mental-health counselor, or addiction counselor may be a better match for defined counseling or recovery-support work. An FNP or primary-care PA may fit a clearly scoped integrated or community primary-care need. A psychiatric RN may provide nursing care and coordination within the organization’s model.

These are examples to guide the discussion, not a list of interchangeable workers. Each profession has distinct education, competencies, and legal scope. Confirm role design with clinical leaders, review the applicable state and organizational requirements, and avoid assuming that one hire can cover a set of unrelated gaps.

• AANP: Scope of Practice for Nurse Practitioners

Design the handoffs before recruiting

For each responsibility, name who owns it, who is consulted, what information moves between roles, and how the team knows the work is complete. Consider the real rhythm of the program: shared visits, warm referrals, medication follow-up, group care, crisis services, or virtual encounters. A short workflow map can reveal whether the solution is a new position, a changed process, or both.

Then define how the role will be supported: clinical supervision or consultation, peer access, documentation systems, scheduling, and the people who handle administrative tasks. These details matter to candidates and are part of assessing whether the organization is ready to recruit for the role.

Keep the search selective and specific

Set essential qualifications, preferred experience, work conditions, and the interview decision in writing. Give candidates a clear preview of the care model and of how the new hire fits the team. If stakeholders disagree about the role, resolve that before the search begins so candidates are not asked to reconcile different versions during interviews.

CTG’s focus includes PMHNPs and specialized behavioral-health nurses, with select searches for therapists, counselors, psychiatrists, PAs, and primary-care NPs when the need and candidate fit are well defined. We learn the position and the employer’s mission, then introduce candidates with context on the match and questions that still need discussion.

• See how CTG builds a focused search

Check whether a new position addresses the bottleneck

Map a few recent examples from referral to follow-up. Note where patients waited, where ownership changed, and what information the next person needed. The pattern can show whether the gap is clinical capacity, unclear responsibility, a scheduling constraint, or a handoff that needs redesign.

If additional clinical capacity is needed, use that workflow to define the position and its measures of success. If the blockage sits elsewhere, adjust the process alongside the search. This gives the new hire a workable place in the team and makes the hiring rationale clear.