Medical case manager job description

Date Issued: November 2019, revised September 2022

Job Summary:

Non-Medical Case Management Services (NMCM) provide guidance and assistance in accessing medical, social, community, legal, financial, and other needed services. Non-Medical Case management services may also include assisting eligible clients to obtain access to other public and private programs for which they may be eligible, such as Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer’s Patient Assistance Programs, other state or local health care and supportive services, or health insurance Marketplace plans. This service category includes several methods of communication including face-to-face, phone contact, and any other forms of communication deemed appropriate by the RWHAP Part recipient.

Essential Functions:

1. Initial assessment of service needs.

2. Development of a comprehensive, individualized care plan

3. Develops monthly clinical scheduling and staffing for uninterrupted client services and

completion of required caseload.

4. Continuous client monitoring to assess the efficacy of the care plan

5. Re-evaluation of the care plan at least every 6 months with adaptations as necessary

6. Ongoing assessment of the client’s and other key family members’ needs and personal

support systems.

7. Collaborate with Medical Case Managers and Outreach Coordinator to ensure coordination

of care.

8. Assist/provide medical transportation

9. Housing services to provide transitional, short-term, or emergency housing assistance to

enable a client or family to gain or maintain outpatient/ambulatory health services and

treatment. Housing services include housing referral services and transitional, short-term,

or emergency housing assistance.

10. Referral for food bank/home delivered meals as needed

11. Emergency Financial Assistance which provides limited one-time or short-term payments

to assist the RWHAP client with an emergent need for paying for essential utilities,

housing, food (including groceries, and food vouchers), transportation, and medication

12. Provide aggregate client data reports and narratives as requested.

13. Perform timely entry into the Electronic Health Record and CAREWare.

14. Participates in outreach and inreach activities to promote services and solicit referrals.

15. Other relevant duties as assigned by supervisor

Nonessential Functions:

16. Participates in various committees/meetings in the community, as it relates to case

management or relevant programs to ensure agency participation

17. Participates in team/staff meetings, attends in-service meetings and applicable workshops

18. Performs other duties as assigned by supervisor.

Competencies:

Quality

Respect

Teamwork

Equity

Integrity

Commitment

Supervisory Responsibility

None

Managerial Responsibilities

None

Minimum Qualifications

1. AA in Community Health required; Bachelor’s degree preferred (or a minimum two years of case management experience may be a substitute for degree)

2. At least 2 years of experience in HIV/AIDS field

3. Knowledge of HIV/AIDS, STI’s Hepatitis C and other health disparities that impact the Black/African American community

4. Sensitivity to populations at increased risk for HIV acquisition (through injectable drug use, exposure to an intravenous drug user, high-risk sexual activities such as commercial sex, street, and homelessness)

5. Sensitivity to ethnicity, culture, gender, sexual orientation, values, beliefs, and behaviors

6. Strong organizational skills and attention to detail

7. Excellent written and oral communication skills

8. Ability to multitask in a fast-paced work environment

9. Positive, professional, team-oriented attitude

10. Proficient in Microsoft Word and Excel

The Early Intervention Program is compiled of trained staff. The overall goal of this program is to assist persons with HIV infections or at a high risk for HIV infection through: HIV risk reduction counseling and testing, partner involvement in risk reduction and transmission prevention, appropriate medical evaluation and full clinical care.

A medical case manager serves as a liaison between a patient with long-term health issues, doctors and medical staff, and the patient s family and friends. While a medical case manager does not offer medical diagnoses or treatment, she does monitor the patient s treatment plan to ensure that those responsible for carrying it out are doing their respective jobs properly. While a medical case manager often works to benefit patients, some managers may work for insurance carriers.
Responsibilities
Coordinate and provide care that is safe, timely, effective, efficient, equitable, and client-centered
Handle case assignments, draft service plans, review case progress and determine case closure
Help clients achieve wellness and autonomy
Facilitate multiple care aspects (case coordination, information sharing, etc)
Help patients make informed decisions by acting as their advocate regarding their clinical status and treatment options.
Develop effective working relations and cooperate with medical team throughout the entire case management process
Arrange abeyances with social services, health and governmental agencies
Take the extra mile and interact with patients to keep track of their progress and to ensure satisfaction
Record cases information, complete accurately all necessary forms and produce statistical reports
Promote quality and cost-effective interventions and outcomes
Assess and address motivational and psychosocial issues
Adhere to professional standards as outlined by protocols, rules and regulations. Educational Skills Required (Degree(s), Certification(s), License, etc.) Bachelor of Science in Social Services or related fields; Certified Bachelor of Science in Social Services preferred. Work Experience Required Previous case management experience-one year minimum; Previous experience with people living with HIV/AIDS preferred; Computer literate; Proficient at WORD, Excel, PowerPoint and Outlook, a plus; Proficient at Internet searches and E-Mail, a plus; Communication/telephone skills.

Bebashi-Transition to Hope is a multi-purpose health and social services agency. We provide culturally sensitive health-related information, direct services, education, research, and technical assistance to reduce and eliminate HIV/AIDS as well as other health disparities and hunger, within the urban community of Philadelphia and vicinity.

Bebashi Transition to Hope is seeking a Medical Case Manager to work with clients in underserved communities; primarily African-American and Latino communities.

The Medical Case Manager will carry a caseload where they will be responsible for completing comprehensive psychosocial needs assessment, developing care plans and linking HIV+ individuals with needed services and resources. The MCM is responsible for providing intensive medical case management and supportive services to persons living with HIV/AIDS.

The qualified candidate will possess an Bachelor’s degree (Master’s preferred) in Social Work or a human services or a related field plus 2 years of experience working with high-risk HIV clients and HIV/AIDS education, certified in HIV/AIDS prevention and testing, willingness to travel to impoverished areas of Philadelphia, superior verbal and written communication skills and the ability to work with people from all walks of life and ethnicities. Must have working knowledge of MS Office products. Bi-lingual in Spanish a plus

Bebashi Transition to Hope is a healthcare agency and all employees are required to be fully vaccinated for COVID-19.

Bebashi is an essential health agency permitted to remain open during this public health crisis. Bebashi has implemented a Vaccine Mandate in accord with the Philadelphia COVID-19 Vaccination Mandates.
COVID-19 considerations:
All staff is provided with appropriate PPE. Staff and Clients receive temperature checks upon entering the building. There are sanitizing stations throughout the building.
Bebashi is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, gender, sexual orientation, gender identity or expression, veteran status or any other status protected under federal, state or local law. We are committed to inclusion, equity and diversity.
Keywords: Prevention, health education, HIV/AIDS, Bi-lingual (Spanish)
Company DescriptionBebashi Transition to Hope's mission is "To provide culturally sensitive health related information, direct services, education, research, and technical assistance to reduce and eliminate HIV/AIDS and other health disparities within the urban community of Philadelphia and vicinity." We're also expanded to fight other challenges like hunger and breast cancer. We are the country's first minority AIDS services organization and the largest in the Commonwealth of Pennsylvania.