Description: Statement of Purpose: Provides outpatient HIV medical case management services and patient advocacy through education, counseling, advocacy, benefits assessment and enrollment, and coordination of services. Ensures patient access to essential medications, medical care, and support services. Primary Tasks: Screen all clients for program eligibility, completes biannual reassessments for eligibility enrollment. Verifies insurance coverage and coordinates the necessary pre-authorizations. Develops, coordinates, and implements individual plans of care biannually Provide referrals, linkage and coordination of services to community partners in accordance with local, state and federal program guidelines. Responsible for RW, HOPWA and ADAP Premium Plus case management and all other case management assignments. Provides access to case management services in a variety of confidential locations including the clinic and patients’ home. Ensures the integrity of case management records through the audit review process. Submits timely and accurate monthly billing documentation and maintains client case management files. Processing needed paperwork for Patient Assistance Program. Complies with all program requirements; is up to date with all changes of the programs. Collaborates with clinic team members to coordinate patient services. Processes documentation required by state and local funding sources as required. Maintains confidentiality regarding patient and/or family in accordance with professional standards and applicable laws. Promotes and practices CAN Community Health, Inc.’s mission and values, and follows its policies and procedures. Ensures confidentiality is maintained by CM team regarding patient/client information in accordance with HIPAA, professional and departmental standards. Secondary Tasks: Cross trains for effective team participation. Develops and fosters networking relationships with community and support resources Practices safety, environmental and/or infection control methods. Continues professional training and education to advance knowledge and skills of HIV/AIDS. Participates in continuous quality improvement of services rendered to CAN clients. Utilizes resources and supplies in a cost-effective manner. Demonstrates courtesy respect in all interpersonal relationships with CAN clients, staff, and visitors. Maintains professional manner in all aspects of job tasks. Performs all other duties as assigned. Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Responsible To: Manager of Case Management Services Employee signature below constitutes employee’s understanding of the requirements, essential functions and duties of the position. Requirements: Education/Professional Experience: 1. Bachelor’s degree from an accredited school or equivalent experience in social services. 2. HIV prevention/intervention experience 3. Basic Annual Safety Training, HIV 104, 500 and 501 Knowledge, Skills and Abilities Required: Valid driver’s license Reliable personal transportation and/or the ability to effectively arrive and depart work independently. Effective communication and interpersonal skills with patients, visitors and staff members. Visual and auditory acuity Ability to utilize problem-solving techniques, a self-starter, work effectively, organized and perform multiple tasks simultaneously. Ability to read, understand, follow, and enforce safety procedures. Demonstrates appropriate organizational skills Willingness to utilize computer software programs. Accurately coordinate several tasks at one time. Able to work with minimal direct supervision Must be willing to travel to conferences, trainings, meetings, etc.
Salary: $43.5K - $49.4K a year
Employment Type:
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