Description

Comprehensive Health Care

Position Description: Medical Case Manager

Department: Case Management

Supervisor: Case Management Supervisor / CEO

Approved By: CEO / Case Management Supervisor

Approved Date: 05/22/2024

FTE: 1.0

Summary

Provide medical case management services to clients and their families by performing the following duties according to Ryan White HIV / AIDS manuals and guidelines.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Complete initial and on-going assessments of client's and family members’ needs and personal support systems.
• Work with Non-Medical Case Managers will maintain client eligibility for services at least every year.
• Develop comprehensive, individualized service plan; coordinate services required to implement plan; client monitoring to assess the efficacy of plan.
• Periodically re-evaluate and adapt plan as necessary over the life of the client, including client advocacy and review of the utilization of services.
• Maintain working relationships with staff of other agencies and institutions, homes, and facilities.
• Work collaboratively with medical staff.
• Develop and maintain contact with other agency staff and local service providers to develop specialized services for clients.
• Encourage clients to do things for themselves to retain feelings of independence and self-esteem.
• Prepare and maintain electronic case records, notes, and forms; perform case follow-up and closing; perform other administrative tasks as required.
• Keep client eligibility and case management files up to date.
• Follow the purchase order system to provide pharmacies and other vendors authorization for medications and services, including ensuring that the correct funding stream is utilized with the assistance of the Purchase Order Clerk.
• Assisting clients with emergency financial assistance, including food bank and gas cards.
• Schedule clients’ medical and transportation appointments with the assistance of the clinic Referral Specialist.
• Cover case loads while other case managers are out.
• This position may require the employee to transport patient information in their personal or company vehicle. This information must be secured during transport.

Supervisory Responsibilities

This job has no supervisory responsibilities.

Need to Know Access

The Case Manager is granted access to case management files for their own clients and those of other Case Managers that they may cover in the event of an absence. The Case Manager will have access to the shared network and support level access to the CAREWare database for all demographic, annual review, client data, case notes, forms, referrals and services data entry as well as the State of Florida CAREWare database for uploads and eligibility documents. She/he will also have access to the patient/client insurance screening portal. She/he will also have access to the agency EHR to review charts and coordinate efforts with the clinic staff. Case Managers will also have Read-Only Access to Provide Enterprise to review client’s ADAP enrollment and to ensure RW Program Integrity throughout the service area. 

Requirements

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

• Job Knowledge - Competent in required job skills and knowledge; exhibit ability to learn and apply new skills; keep abreast of current developments; require minimal supervision; display understanding of how job relates to others; use resources effectively.
• Use of Technology - Demonstrate required skills; adapt to new technologies; troubleshoot technological problems; use technology to increase productivity; keep technical skills up to date.
• Teamwork - Balance team and individual responsibilities; exhibit objectivity and openness to others' views; give and welcome feedback; contribute to building a positive team spirit; put success of team above own interests; able to build morale and group commitment to goals and objectives; support everyone's efforts to succeed.