Care Manager

Los Angeles LGBT Center•Los Angeles, CA

About The Position

Under the supervision of the Manager of Nurse Case Management Services, the Care Manager, will provide medical care management and overall support services to patients while ensuring that case management services operate within industry standards and meets all contractual requirements and guidelines. The Care Manager must be a Registered Nurse and will work in collaboration with staff to implement, monitor and maintain program guidelines. This will include but not be limited to initial nursing assessments, chronic disease management/treatment protocols, referral process, authorization process, linkage to care and facilitation of client access to primary health care.

Requirements

Knowledge of or experience working with the LGBTQ community and familiarity with issues of particular relevance to LGBTQ people.
A passion for the Center’s work and its mission to make the world a better place for LGBTQ people.
Holds current California Registered Nurse License.
Holds current AHA CPR Certification.
Minimum of 3 years of experience in direct patient care; preferably in an ambulatory care setting.
Minimum of 2 years of experience in Case Management.
Basic knowledge of HIV/AIDS, other infectious diseases and state/federal reporting requirements.
Knowledge of quality assurance/management/improvement as well as DHSP and other regulatory standards including state/federal laws, rules, and regulations.
Understanding of the global effect of HIV/AIDS on the person, their family members, and significant others.
Excellent verbal and written communication, organizational, detail and interpersonal skills.
Excellent Computer skills and knowledge of Microsoft Office, word processing, Electronic Health Records, and other software systems.
Ability to be self-motivated and dedicated to initiating and completing complex tasks.
Ability to handle multiple tasks, be detail-oriented and maintain strict confidentiality of medical information.
Able to work well independently with minimum supervision.
Demonstrated ability to work effectively with people of diverse races, ethnicities, nationalities, sexual orientations, gender identities, gender expression, socio-economic backgrounds, religions, ages, English-speaking abilities, immigration status, and physical abilities in a multicultural environment.

Nice To Haves

BSN or MSN, a plus.
AIDS Care Registered Nurse (ACRN) Certification Preferred.
Experience in HIV/AIDS, Hepatitis C and chronic disease care/management preferred.
Bilingual skills, a plus (English/Spanish fluency preferred).

Responsibilities

Serves as part of a multidisciplinary care team to provide a range of patient care services.
Collaborates with healthcare providers, case management staff, Health Services staff and outside organizations in planning, organizing, and implementing patient care plans for chronic disease management (e.g., HIV, Hepatitis C, Diabetes).
Provides oversight and support to the LVN Nurse Case Managers.
Ability to make independent and substantial decisions.
Provides outreach and ensures that clients are aware of services available.
Works in collaboration with staff members to develop, implement and maintain an effective and efficient Utilization Management Program.
Collaborates with other team members to implement specialty referral guidelines and to determine patient’s eligibility for referral authorization, i.e., Medi-Cal/Medicare status.
Collaborates with staff members regarding the coordination of specialty referrals per clinic protocol to all specialty consultants and ancillary health care services.
Make appropriate referrals to ancillary team members, i.e., Housing Case Management Staff, Nutritionist, Pharmacist, etc.
Consult with staff on service coordination and service plans for clients in the MCC program.
Ensures that the nurse case management staff promotes continuity of care and follow-up of clients.
Serves as a liaison between specialist consultants and the Health Services department.
Develops materials and assists with health care education for client, partner and family members.
Ensures that there is clear and concise communication, including case presentations, written progress notes, medication lists, summaries and reports.
Oversees the coordination services of outside agencies such as home health, hospital admissions and hospice care.
Supports the monitoring of specialist appointments for reconciling the funding, billing and reporting requirements.
Provides and oversees staff members who provide skilled nursing care to patients, including but not limited to administering medications, treatments and screening procedures as ordered and within the scope of practice of the license.
Performs and oversees assessments per Los Angeles LGBT Center, DHSP, Health Resources and Services Administration (HRSA) and other regulatory agency guidelines.
Assists with staff training, development and mentoring.
Triage patients as needed.
Maintain complete and accurate files documenting all care and services provided in the client’s health record and all other required documentation methods.
Interact in a professional manner with health services staff and patients.
Exercise appropriate judgment and decision-making skills.
Use standard office machinery including personal computers and printers in performance of duties.
Assist in data auditing tasks, prepare reports as required, and submit in a timely manner.
Participate in staff meetings, agency meetings, planning meetings, case conferences, and other meetings as needed.
Comply with requirements of OSHA, HIPAA, and other applicable regulations.
Other duties as assigned.