A Clinical Case Manager coordinates medical care and provides advocacy to help people get the best and most affordable care. Helps patients navigate insurance and hospital bureaucracies and access information. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment and travel to different doctors' offices, hospitals or a patient's home.
Medical Case Manager AID Atlanta - 4.2 Atlanta, GA Job Details $22.21 - $23.17 an hour 5 hours ago Benefits Fuel card Health insurance Qualifications Bachelor's degree Full Job Description
JOB SUMMARY
The Medical Case Manager (MCM) works with members to remove barriers to
HIV/AIDS
medical care by facilitating a collaborative process that identifies members' needs, a plan to address those needs, and continuous follow-up to ensure that members obtain the necessary services that help them to maintain adherence and retention to medical care. The MCM also coordinates with other service providers through a comprehensive and active referral process to link HIV+ individuals into appropriate services and care.
ESSENTIAL DUTIES & RESPONSIBILITIES
Provide direct service coordination and support to people living with
HIV/AIDS
in accordance with the Ryan White Part A & EHE case management standards of care. Provide Case Management services to members on a walk-in, scheduled, and on-call Manage a caseload of up to 50 members. Per Ryan White Part A & EHE Case management standards, medical case managers must conduct an initial comprehensive assessment, intake, and EMA screening for every member receiving Ryan White services. Collaboratively develop and implement Individualized Service Plan (ISP) for each member on caseload, including conducting ISP updates every 4- 6 month for each member depending on Medicaid status. Assist members with housing applications and referrals, coordinate medical transportation needs (UBER, Gas cards), issue food vouchers/gift cards, assist with dental appointments, and other financial assistance. Refer eligible members/patients to pharmacy services onsite. Assess and evaluate members' initial needs through the EMA screening tool. Focus on improving the clinical and life outcomes of members/patients by working with them to improve their retention to medical care rates, viral load rates and quality of life. Educate members about Case Management, and policies (Grievance, HIPPA, Member's Rights and Responsibilities) and other agency program policies to ensure members have clear expectations of services. Provide regular monthly (or more) contact with members to follow up on treatment plan goals and provide intervention as needed. Advocate and mediate on members' behalf to decrease or eliminate barriers to care, Educate members about the importance of participating in medical care and ensure that members have full access to primary medical care and medication. Assess and Educate members about the importance of medication and medical adherence to improve member's clinical outcomes. Assess and educate members about harm reduction, prevention, and other HIV-related sexual transmitted infections (STIs). Conduct home and hospital visits, accompanying members to appointments as needed. Organize and facilitate new member orientation to ensure members have a clear understanding of how Case Management can be utilized beneficially. Assess, verify and maintain records of a member's eligibility for Case Management and various entitlement programs. Document all encounters with or on behalf of a member within 72 hours in the Electronic Medical Records (EMR) system. Assess, collect, and maintain accurate member information and records in a confidential manner. Complete monthly reporting to ensure accurate programmatic reporting (based on position/site assigned). Provide active referrals and application assistance and support to members. Educate members about various community resources and programs to increase their knowledge of appropriate referrals. Collaborate with physicians, nurses, and other clinical staff in the development and execution of member's plan of care. Attend monthly interdisciplinary meetings with medical providers (based on-site). Maintain up-to-date resources of community services Attend regular and mandatory training (including Client Services, Ryan White, EHE, HOPWA, and others as assigned). Complete all Health stream and required member services and HCC trainings annually or as assigned Participate in and volunteer for intra and interdepartmental activities/events across the agency (i.e. AIDS Walk fundraising, agency sponsored events, member centered events, etc.). Communicate regularly with manager about changes, updates, and/or improvement suggestions in service delivery issues or other agency-related issues that directly or indirectly impact staff and/or members. Attend agency, local, state, and national meetings, conferences, or workshops as needed or required. Adhere to policies and procedures for AID Atlanta and other off-site programs to ensure quality standards are met. Abide by NASW code of ethics, HIPPA and Atlanta EMA Case Management Standards to ensure a high level of professionalism is maintained. Address members concerns utilizing the Customer Service Standards and grievance Perform routine self-audits and maintain charts to ensure members' information and eligibility documents are current. Meet with supervisor at least monthly to staff member cases, discuss chart audits/observation results, and to discuss performance and progress of stated goals. Attend all required internal and external (for off-site). Participate in various mandatory trainings held internally and externally ensuring a continuous knowledge base of programs that benefit members. Be a participant in the hiring and training of new case managers as requested by manager.
SUPERVISORY RESPONSIBILITIES
None
QUALIFICATIONS
EDUCATION & WORK
EXPERIENCE
Bachelor's degree in social work, psychology, sociology, human services or social services-related. 1-2 years experience in the field of social work/case management or similar field. Experience in the field of HIV is preferred, but not required. Must pass criminal background check.
Requirements:
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE
at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people's lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of
HIV/AIDS
medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF's core values are: Patient-Centered Value Employees Respect for Diversity Nimble Fight for What's Right Please review our Advocacy page for the latest news on how AHF is Fighting for What's Right! Advocacy News. Benefits at AHF AHF offers comprehensive benefits to help our employees do and be their very best! These benefits are intended to enhance employee physical, financial, spiritual and professional health.
