Medical Case Manager

Position Summary

The Medical Case Manager provides medical case management/treatment adherence services for The Hidden Garden Program.

Essential Functions

• Confirm Ryan White eligibility and applicable documentation

• Receive referrals from outreach staff and ensure compliance with eligibility requirements for all clients, including HIV status, residency, income, insurance documentation, and client signatures on agency forms.

• Refer client to primary medical care for follow up visits, labs, and prescription.

• Monitor initial assessments, care plans and overall encounters to ensure identified client needs, goals, and interventions are developed and updated with staff and client signatures to ensure compliance with state and federal outcome indicators and standards of care.

• Determine the level of case management assistance required and frequency of visits.

• Make appropriate internal and external referrals to core medical and other health and support services and work with Case Assistant until they have been resolved.

• Monitor completion of insurance applications.

• Maintain face to face, telephone, home visits and other encounters with and on behalf of the client and document progress toward achievement of care plan goals.

• Provide treatment adherence support, advocacy, consultation, and crisis intervention to the client and other family members.

• Provide monthly narratives identifying barriers with solutions to system and operations challenges.

• Provide liaison support to Consumer Advisory Board (CAB).

• Facilitate monthly health education or support group.

Core Responsibilities and Organizational Expectations

In addition to role responsibilities, every employee has the following responsibilities as a part of their employment:

· Provides courteous, responsive, and service-oriented support to patients, visitors, and colleagues. Promotes a respectful and welcoming environment, communicates clearly, and works collaboratively to support team and organizational goals.

· Performs all duties in a manner consistent with Park West Health System’s mission, vision, and organizational values, demonstrating a commitment to quality care, respect, and service excellence.

· Adheres to all applicable federal, state, and local regulations, as well as organizational policies and procedures, including HIPAA, privacy, and security standards.

· Follows all infection control, workplace safety, and risk management protocols. Participates in quality improvement and performance initiatives as appropriate to the role.

· Maintains professionalism, reliability, and accountability in attendance, performance, and communication. Completes required trainings and maintains job-related competencies.

· Participates in staff meetings, trainings, and organizational initiatives. Supports operational needs and performs other related duties as assigned to ensure efficient and effective operations.

· Performs other duties on an as-needed basis.