Medical Case Manager HIV Care Coordination Hybrid Remote

Southwest Healthcare • Santa Fe, NM

4d • Hybrid

About The Position

Southwest Care Center is seeking a full-time Medical Case Manager for our Santa Fe & Albuquerque clinics. This is a hybrid remote position, with the opportunity to work two days in clinic and three days remote. The role involves completing intakes, assessing client needs, linking clients to services, coordinating care, and ensuring viral load suppression for clients living with HIV/AIDS. The position requires a commitment to inclusivity and diversity, maintaining confidentiality, and meeting performance standards. The Medical Case Manager will document client interactions in the electronic health record and collaborate with clinical staff for prior authorizations. A strong understanding of applicable grants, regulatory requirements, and patient counseling is necessary.

Requirements

• Bachelors of Social Work (BSW) or Masters of Social Work (MSW); or Bachelor’s degree from an accredited college or university + 2 years of exp. working with HIV diagnosed populations, chronic illness populations, or underserved populations; or Associates or Certified Community Health Worker + 2 years of exp. working with HIV diagnosed populations, chronic illness populations, or underserved populations; or High School Diploma or Equivalent + 4 years of exp. working with HIV diagnosed populations, chronic illness populations, or underserved populations.
• Education above the minimum requirements can be substituted on a year for year basis.
• NM DOH Counseling, testing and referral services certification (provided upon hire)
• NM DOH Harm Reduction and Prevention Certification (provided upon hire)
• Basic Life Support (BLS)

Responsibilities

• Complete an intake with people living with HIV/AIDs interested in case management services, assessing client-specific information, barriers to care, and urgent needs.
• Work with peers and team members to orient the client/patient to the organization, including site tours, overview of available resources, and introductions to the treatment team, wrap-around teams, and others.
• Meet with clients/patients to complete additional intake paperwork, authorizations, and consents based upon desired services.
• Provide clients/patients with linkage to an insurance assister if needed, obtain required documentation, and assist with applications for medication assistance or ADAP as needed.
• Promote client/patient access to internal agency services including support groups, housing services, food programs, behavioral wellness, substance use treatment, and medical care.
• Be responsible and accountable for coordinating all aspects of client/patient care as listed on the service plan.
• Provide Medical and Non-Medical case management for enrolled clients/patients with the specific goals of achieving and maintaining viral load suppression.
• Schedule client/patient appointments with required staff at SCC, identify available community-based resources, and actively manage appropriate referrals, access, engagement, follow-up, and coordination of services identified on the service plan.
• Conduct engagement services (including hospital visits, reminder phone calls, transportation, etc.) to increase the likelihood that clients/patients will attend appointments at SCC and follow up with clients/patients regarding missed appointments.
• Conduct assessments, re-assessments, case conferences, and service plan development with the client/patient and multidisciplinary team to reduce barriers to retention and adherence.
• Ensure that all client/patient interactions are documented in the client/patient electronic health record and e2NM within the designated time frame.
• Be responsible for contacting and tracking clients/patients who are not virally suppressed and lost to care.
• Coordinate case conferences/communication to address client/patient needs, ensuring a case conference/communication with the treatment team for all clients/patients who are lost to care.
• Based on outcomes of case conferences/communication, link clients/patients to services such as the Treatment Adherence Program, Behavioral Wellness, partner notification, health education, housing, transportation assistance, etc.
• Respect and support inclusiveness and diversity, including but not limited to individuals of diverse backgrounds, cultures, races, ages, sexual orientations, gender identities or expressions, transgender, experiences, opinions, etc.
• Demonstrate commitment to SCC’s behaviors and business impacts and model them in the organization.
• Maintain the confidentiality of all client/patient, employee protected, and proprietary information.
• Meet the performance standards of their department and participate as requested in compliance audits, process improvement, and quality improvement plans.
• Perform routine and appropriate documentation in the electronic health record of client/patient barriers to care, progress, care plans, changes, and notes to ensure SCC can adequately report in the Ryan White Services Report (RSR).
• Perform identified prior authorizations; collaborate with clinical staff and providers for necessary supporting documentation.
• Maintain an appropriate level of working knowledge regarding applicable grants and other program funds, regulatory requirements (such as FQHC, PCMH); patient counseling, guidance and all documentation are consistent with meeting such requirements.
• Perform other duties as assigned.

Benefits

• Generous time off plans including sick and holidays.
• Tuition reimbursement and other professional development programs.
• Full benefits package including medical, dental, vision, 401k, supplemental life and spousal coverages, employer paid disability, and access to the 340B prescription program if a patient at SCC.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level