Ryan White Medical Case Manager

Lutheran Social Services

Position Description:

Division/Department:  Advocacy, Care, & Education (ACE)

Job Title: Ryan White Medical Case Manager 

Reports to (Title): RWMCM Program Supervisor

Job Code:

FLSA Status:   Non-Exempt

Manager (with direct reports)? Yes No X

Location: Jacksonville

SUMMARY:

This position provides services to clients with HIV/AIDS who are enrolled in the Advocacy, Care, & Education program. The ideal candidate will possess a strong background in HIV care or other Medical Case Management, exceptional organizational skills, and the ability to collaborate effectively with cross-functional teams. The MCM will be responsible for maintaining a client load of approximately 70 clients and ensuring they are receiving the care and services they need to lead healthy and successful lives.

ESSENTIAL DUTIES & RESPONSIBILITIES:
Client Assessment:

• Conducts needs assessments of clients with HIV in the outpatient and hospital setting for clients to receive comprehensive medical, social, and community resources on an ongoing basis.
• Conducts home visits as needed to ensure timely access to and coordination of medical and psychosocial services.
• Assesses client stability and provides referrals to increase level of stability and self-sufficiency.
• Conducts psychosocial assessments, developing, implementing, and revising individualized plans of care, family support plans, and discharge plans on an ongoing basis.
• Engages a medical consult with the attending physician for each client as needed.
• Serves as an advocate, caretaker, listener, encourager, and enforcer as needed.
• Educates, links, and refers clients to follow-up medical care and community resources to address needs in collaboration with other Ryan White Network Providers.
• Advocates for clients’ unmet needs, providing clinical intervention as needed.
• Assists with insurance issues, Medicaid, Medicare, and other public assistance services.
• Assures client awareness of all Ryan White Programs and available community services and advocates for accessibility to all services. 
• Provides referrals for mental health, substance misuse, home care, food, transportation, and other support services for people living with HIV.
• Works collaboratively with network and community agencies to ensure comprehensive care for clients.
• Provides linkages to agency, community, and government services and monitors referral completion, including state insurance continuation programs, ADAP, medication assistance programs, benefits/health coverage programs such as AND, SSI, SSDI, Medicaid, Medicare, and Housing Programs, etc.
• Maintains patient confidentiality and HIPAA compliance in all physical and digital documentation. 
• Maintains documentation of and documents all interactions and paperwork within 72 business hours in EMR systems.
• Assist clients in identifying available benefits, including social and community services, when their case manager is not available
• Participate in community outreach activities Other duties may be assigned as needed; Duties may vary and evolve over time based on organization needs and priorities

WORK EXPERIENCE & JOB RELATED SKILLS (Required/Preferred)

Required:

• Experience and knowledge of HIV and Ryan White
• 1 year of proven experience in case management
• Computer skills – Microsoft Suite, electronic health records systems, digital communication systems
• Good clinical knowledge of human behavior; Good interpersonal skills.
• Must have excellent organizational skills. Ability to prioritize work and handle multiple tasks. 
• Must be able to communicate orally and in writing in English without an interpreter or translator. 
• Must be very detail-oriented and capable of thinking independently while exercising good judgment. Required to make independent judgments without supervision.  Must be able to generalize evaluations or decisions based on sensory or judgmental criteria.
• Must be able to perform under stress when confronted with emergency, critical, or unusual situations. 
• Must be capable of dealing with periodic cyclical workload pressures & levels of responsibility.  
• Requires the ability to work with people beyond giving and receiving instructions.
• Possess and maintain a valid driver’s license and auto insurance; must be able to transport clients to various locations by using own transportation.
• Excellent communication and collaboration skills, with the ability to work effectively across functional teams.

EDUCATION, CERTIFICATION, LICENSURE  (Required/Preferred)

• Spanish or French speaking and writing fluency preferred.
• Bachelor's degree in Sociology, Public Health, Social Work, or a related field required.
  • Experience in Medical Case Management or an HIV related field may be substituted for educational experience.
• Completion of AETC MCM online training within 90 days of hire. HIV 101 training required, or completed within 90 days of hire.
• Screening required for this position: a Level 2 background check (company paid through the Background Clearinghouse - https://info.flclearinghouse.com), a drug screen (company paid), and a driver's license check (company paid) - all at time of job offer

REQUIRED JOB COMPETENCIES  (Behaviors For Effective Job Performance) 

• Attendance
• Customer Focus
• Computer literacy
• Flexibility
• Professional Competence
• Timely Decision-making
• Cultural Competency
• Self-starter/Self-efficacy Organization

WORK ENVIRONMENT/PHYSICAL DEMANDS

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Activity

(If more than 2+ hours per day)

Standing   Sitting   Mobility   Climbing   Balancing

Writing   Crawling   Squatting   Bending   Filing   Twisting

Lifting to Include

Up to 10 lbs.   11–25 lbs.   26–60 lbs.

61–75 lbs.   Over 75 lbs.

Pushing  Pulling   Carrying

Environmental Conditions

Cold   Heat   Wet and/or Humid   Noisy

Vibration   Fumes   Dust   Odors   Mists

Sensory

Hearing to Converse  Hearing to Use Telephone  Talking    Tasting/Smelling   Reading Distance 1–5 ft.        Reading Distance 10–30 ft.

Driving

Incidental Driver   Regular Driver

Keying

Occasionally (2–3 hours weekly)

Frequently (2–3 hours daily)

Continuously (4+ hours per day)

External Environment: 

External Environment is dependent on client population.

The statements included in this Job Description are intended to describe the general nature and level of the work being performed by the person assigned this job.  They are not intended to be an exhaustive list of all responsibilities, duties and skills required.