Medical Case Manager

POSITION TITLE : Medical Case Manager

DEPARTMENT : Clinical Services

FLSA STATUS : Exempt

PAY GRADE : 9

REPORTS TO : Senior Director Clinical and Support Services

GENERAL DESCRIPTION OF DUTIES

The Medical Case Manager will administer the Medical Case Management program for People Living with HIV (PLWH). The Medical Case Manager will integrate the agency’s mission and core values in the provision of services to help PLWH access the medical and support care to improve their health and achieve higher quality of life.

SPECIFIC DUTIES AND RESPONSIBILITIES

ESSENTIAL JOB FUNCTIONS

The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification.

It is not necessarily descriptive of any one position in the class. The omission of an essential function does not preclude management from assigning duties not listed herein if such functions are a logical assignment to the position.

• Assess prospective clients for eligibility for Ryan White services
• Coordinate access to primary care for Ryan White clients
• Refer clients for other core medical services and monitor such linkages
• Supervises staff and volunteers
• Regularly scheduled check-ups of clients to include weight, blood pressure and other vital signs
• Arrange and receive medical files, including suppression of viral load and CD counts
• Provide individual and group counseling
• Ensure compliance with all patient confidentiality regulations, including HIPAA
• Client-specific advocacy and supervision of case conferences with care teams
• Work with clients to develop workable and measurable Individual Care Plans (ICP)
• Regularly monitor ICPs and amend as needed
• Oversee treatment adherence
• Educate clients regarding HIV / AIDS and co-morbid condition disease processes
• Monitor treatment, progress and receipt of services
• Administer outreach to medical providers throughout Hartford, Middlesex and Tolland counties
• Participate in, coordinate, monitor care teams for clients that will include a variety of providers, both external and internal to the agency.
• Oversee efforts to help client families
• Maintain all data in department database and individual client files
• Maintain accurate documentation of services provided on behalf of clients
• Report to funder on a timely basis
• Assist and participate in evaluation and quality assurance of Medical Case Management services
• Enrollment of Ryan White clients and monitoring of Ryan White 340B Pharmacy.
• Plan and Engage in Outreach with Ryan White team.
• Participate and enroll in Access health Insurance

ADDITIONAL JOB FUNCTIONS

Performs other duties as required

MINIMUM TRAINING AND EXPERIENCE

Education : Bachelor’s Degree in social work or related health or Human Service degree from an accredited institution or an active Nursing license (RN) to practice in Connecticut.

Minimum Years of Experience : Minimum of one-year practical experience including case management of clients.

Active Certification in good standing in : Nursing license (RN) to practice in Connecticut. Valid CT driver’s license with proof of automobile liability insurance.

Demonstrate skills in : Ability to communicate clearly both verbally and in writing. Proficiency in Microsoft Office Suite.

Experience with using medical databases and computer programs, CAREWARE preferred. Ability to handle and prioritize multiple tasks while maintaining attention to detail in a fast-paced environment.

Knowledge of : Knowledge of the Community and Up-to-date knowledge of HIV and services with HIV positive patients.

Bilingual : YES, Preferred Language : Spanish Fluent Speak / Written English & Spanish

Physical and TB Required : Yes, prior to appointment

Driving Required : YES Agency Vehicle YES Employee’s Own Vehicle YES

Active Driver License in good standing required upon hire and throughout employment

ADA COMPLIANCE

Physical Ability : Tasks involve the ability to exert very moderate physical effort in light work, typically involving some combination of stooping, kneeling, crouching and crawling, and which may involve some lifting, carrying, pushing and / or pulling of objects and materials of moderate weight (12-20 pounds).

Sensory Requirements : Some tasks require visual perception and discrimination. Some tasks require oral communications ability.

Environmental Factors : Tasks are regularly performed without exposure to adverse environmental conditions, such as dirt, dust, pollen, odors, wetness, humidity, rain, fumes, temperature and noise extremes, machinery, vibrations, electric currents, traffic hazards, animals / wildlife, toxic / poisonous agents, violence, disease, or pathogenic