The Medical Case Management, Manager will provide supervision to all internal medical and senior services case managers as well as offer a range of client-centered, confidential services that link clients with core care services including medical, dental, mental health, substance use, and supportive care services including legal, medical transportation, emergency financial assistance, food, and housing services. The goal of medical case management is to ensure viral suppression by taking care of any barriers to care services preventing a client from being undetectable.

The Medical Case Management, Manager will provide leadership and support to the case management team, monitor performance, implement quality improvement projects, and ensure the attainment of positive health outcomes for AFC clients The Medical Case Management, Manager will assist with screening and enrolling eligible clients in the 340B program and will be the care team liaison in all 340 B meetings.

The salary range for this role is $52,000 to $62,000.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Program Management

• Provide leadership and guidance to internal medical case managers.

• Assist case managers in understanding health insurance plans, managed care options for which their clients are eligible and navigating ADAP/MAP applications.

• Monitor and guide case managers work and manage relationships with associated subcontractors.

• Assist with managing the processing of payment requests and services provided entries by subcontractors.

• Manage the collection of fees from program participants bi-annual basis

• Document all client level activities in the Provide database.

• Provide database trainings to the case management collaborative as needed

SUPERVISORY RESPONSIBILITIES

• Hire, train, mentor and supervise assigned staff; including assisting with recruitment; selection; scheduling and job assignments, mentoring/coaching; staff development and training; performance evaluation; and recommending salary, disciplinary and other personnel actions in accord with personnel procedures.

• Provide professional development opportunities and guidance to each team member to strengthen their skill sets and job satisfaction; meet regularly with assigned staff to identify priorities, discuss strategies, and review ongoing projects.

• Medical Case Manager (2)

• Senior Services Case Manager (1)

CLIENT SERVICES

• Conduct face-to-face assessment and reassessments on an annual basis

• Create care plans that match the identified needs of the client

• Ensure that all clients referred to services are eligible prior to the date of service

• Provide care services linkage and re-engagement support to clients, including older adults

• Conduct field visits as needed to RW and HOPWA clients who have disengaged from care

• Conduct outreach services as needed

• Refer clients to appropriate services highlighted in the care plan

• Screen for income supports for benefits and entitlements to advocate on behalf of client

• Complete emergency financial assistance applications for eligible clients

• Complete payment requests as needed for copays and other out of pocket costs

• Document encounters using designated client database accurately and in a timely manner

• Develop and maintains professional relationships with social service, health, and governmental agencies

• Participate in continuous quality improvement efforts

• Participate in regular supervision meetings, team meetings, in house training sessions (12) and conferences as needed

OTHER

• Assist with agency-wide activities as directed, including Annual Meeting, AIDS Run & Walk, and others.

• Protect organization's value and manage risk by keeping information confidential.

• Perform other duties as assigned.

The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. It is not necessarily descriptive of any one position in this class. The omission of an essential function does not preclude management from assignment of duties not listed herein if such functions are a logical assignment to the position.

EXPERIENCE AND EDUCATION

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

ENTRY REQUIREMENTS (EXPERIENCE AND EDUCATION)

Minimum Qualifications

• Bachelor's degree in the Human Services field (i.e., Psychology, Sociology, Public Health, Social Work) OR Bachelor's degree in a non-human service field with 2 years of case management experience.

• Must have 1 year of supervisory experience

• Must have at least 2 years of experience in the use of multiple databases housing client level data (e.g. Provide, CaseWorthy), and must be proficient Microsoft office user.

Preferred Qualifications

• Master's degree in the Human Services field (i.e., Psychology, Sociology, Public Health, Social Work).

• Must have 2 years plus of supervisory experience

• Must have at least 3 years of experience in the use of multiple databases housing client level data (e.g. Provide, CaseWorthy), and must be proficient Microsoft office user.

KNOWLEDGE, SKILLS, AND ABILITIES

• Exceptional time management skills

• Strong attention to detail

• Ability to present to large groups, and a comfort level with presentations generally

• Strong customer service orientation

• Ability to work independently and make decisions within span of control

• Dependable and reliable

• Knowledge of HIPAA and ability to comply with HIPAA regulations

• Ability to recognize and solve problems positively and sustainably

REQUIRED CERTIFICATES, LICENSES, REGISTRATIONS

None

WORK ENVIRONMENT AND PHYSICAL DEMANDS

Dependable transportation to conduct field visits. A drivers license, and car insurance may be required. Physical ability to operate a vehicle may be required. The field environment may contain ADA noncompliant spaces. The work environment is representative of that found in a general office environment. Tasks involve the ability to exert light physical effort in sedentary to light work, but which may involve some lifting, carrying, pushing and/or pulling of objects and materials of moderate weight (up to 10 pounds.) Tasks may involve extended periods of time at a keyboard or workstation and on the telephone.