Medical Case Manager
4 weeks ago
Overview of the Position:
Provides direct services to persons living with HIV or AIDS (PLWHA): core and support services, as defined by DHEC and HRSA, that lead to satisfactory health outcomes for clients and aligns with state and federal benchmarks and guidelines. Works closely with the patient and a multi-disciplinary team, developing and carrying out an individual treatment plan / action plan. Performs pre-visit tasks, annual and mid-year assessments, reviews – to include audit and quality improvement activities. Accomplishes linkage to care activities that include ID and Primary Care, specialty care, and support community services.
Education and Experience:
• Must possess a minimum of a bachelor’s degree in social work or hold a four-year degree from an accredited college or university in a human services field and one year of experience in counseling or a related human services field
OR
• Master’s degree from an accredited college or university in a human services field such as social work, sociology, health education, counseling, psychology
Required Skills / Abilities:
• Ability to work with clients from a wide range of backgrounds and lifestyles, while maintaining a non-judgmental attitude.
• Must possess strong documentation skills and the ability to handle multiple tasks.
• Good communication skills
• Must be team oriented
• Provide Advocacy
Supervisory Responsibilities:
• No Direct Reports
Essential Job Functions:
• Completes performance standards established by SC DHEC, ensuring timely and coordinated access to medical and supportive services
• Ensures continuity of care for patients newly diagnosed with HIV/AIDS, re-engaging in care, established in care, and seeking community-based services
• Complies with MCM training requirements and supplemental trainings
• Participates in audit activities, correcting habits and work flow issues as indicated while continuing appropriate practice habits per HH and DHEC guidelines
Competently and accurately utilizes the EMR and PE database to ensure accurate patient records, reporting, tracking of activities and financial resources, and utilization of time and effort
• Ensures that Ryan White eligibility guidelines are followed, properly communicated with patients, and utilized as accountability guidelines for payor of last resort
• Demonstrates a commitment to improving the health outcomes for PLWHA: as indicated by completion of MCM duties that exceed an average performance level – to include completing points-in-care, activities that align with the HIV Care Continuum, and additional services per individual patient needs
• Completes home visits as needed to address patient needs
• Assists patients in resolving issues related to stigma; identifying resources that improve quality of life and health; understanding HIV/AIDS; accessing evidenced based interventions as needed; participating in support groups and/or consumer advisory groups; completion of referrals for needs that extend beyond HH’s service options; reducing barriers to care, and improving patient’s sense of value and purpose
• Attends agency and funder meetings as required to comply with grant standards, acquire information, participate in program and team development, and receive support/supervision from peers and leadership
• Travels as needed to attend meetings, trainings and conferences, and to network on behalf of patients and the agency
• Participates in Quality Improvement activities, to include but not limited to audits, site visits, PDSA cycles, huddles and patient surveys
• Completes other duties as assigned by supervisor
Physical Requirements:
Must be able to lift 30 pounds. Vision and hearing corrected to within normal limits is required. Must have manual dexterity to key in data; utilize computer, grab, grip, hold, tear, cut, sort, and reach.
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