Demo

Cares Medical Case Manager

Community Access Network
Lynchburg, VA Full Time
POSTED ON 8/2/2026
AVAILABLE BEFORE 11/30/2026

Job Description

Cares Medical Case Manager

OVERVIEW:

The Cares Medical Case Manager is a member of the multidisciplinary HIV Care Team. This position works in partnership with the Nursing team and the Medical Provider to assess the health of needs of clients, focusing on behavioral health and substance abuse screening and referral; HIV risk assessment, education and counseling; and education and training on skills building with clients to help them learn to self-manage a chronic disease. Care’s Medical Case Managers may be social workers, nurses or any similar professional with related health and human service experience. Comprehensive HIV case management is a program that includes a series of interactions between case manager and client ultimately resulting in the client reaching his or her optimum level of health, and being able to manage his or her own care. Care’s Medical Case Managers focus on medical and behavioral health needs of clients and linkage to needed supportive services that assist the client to successfully adhere to their HIV treatment program.

ESSENTIAL FUNCTIONS:

  • Provide assessments of the client’s needs and personal support systems, development of an individualized needs assessment and service plan, coordinate services to implement the plan, monitor the efficacy of the plan and periodically re-evaluate the plan as related to clients’ on-going needs. Link client to community resources.
  • Empower client with support, education and community resources to access the services needed to fulfill the needs identified on client’s needs assessment. In addition, advocate for the client within all available resources to obtain services to meet client needs.
  • Educate target populations on all aspects of HIV/AIDS transmission factors, prevention and state of the art HIV/AIDS information. Maintain personal knowledge of HIV/AIDS medical and medication updates.
  • Provide education and risk reduction advice, as appropriate, to assist clients to develop positive behavior change related to mental health, substance use, HIV transmission and self-management.
  • Referral, follow-up and advocacy to appropriate agencies and internal departments required to assist the client in achieving the goals and objectives identified in the individualized Care Plan and as assessed during ongoing education and counseling sessions.
  • Responsible for meeting Ryan White Grant requirements to educate and assist patients with Ryan White entitlements, including sliding fee scale, annual cap on charges, and others as necessary.
  • Monitor HIV medication therapy to include education of client concerning risks and side effects, monitoring client adherence and tolerance of medications.
  • Review and monitor CD4 and viral load (VL) lab values, to include making sure the most current CD4 and VL lab values are recorded in the client file/database.
  • Provide client education about HIV, its transmission, complications, risk reduction and education.
  • Case conference with client’s mental health provider, substance abuse treatment provider, and any other professional working with the client to support their behavioral choices.
  • Case conference with the HIV Care Team, as appropriate and as required by acuity level.

NECESSARY SKILLS/QUALIFICATIONS:

Required:

  • Bachelor of Social Work (BSW) (Masters of Social Work [MSW] and licensure preferred), or other related health or human service degree from an accredited college or university, or
  • Current Virginia licensed Registered Nurse (RN) with additional Association of Nurses in AIDS Care (ANAC) Certification preferred, or
  • Related experience for a period of four years, preferably HIV related regardless of academic preparation.
  • Flexibility to attend meetings and trainings which may fall outside the regularly assigned work hours.
  • Excellent communication skills and ability for detail.
  • Sensitivity to cultural differences and alternative sexual orientations to include the Gay, Lesbian, Bi-Sexual and Transgendered Communities.
  • Sensitivity to the psychosocial issues concerning individuals living with HIV/AIDS.
  • Must have reliable transportation which will enable tasks and responsibilities to be completed in a timely and appropriate fashion. Must provide proof of valid automobile insurance, a copy of which will be placed in the employee’s HR file.

Employment is contingent upon:

  • Successful Background Check
  • Successful Urine Drug Screen
  • Proof of Covid-19 vaccination

Job Type: Full-time

Pay: $19.35 - $25.80 per hour

Benefits:

  • 403(b)
  • 403(b) matching
  • Dental insurance
  • Employee assistance program
  • Health insurance
  • Paid time off
  • Professional development assistance
  • Tuition reimbursement
  • Vision insurance

Work Location: In person

Salary : $19 - $26

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