Lead Case Manager – Dallas, TX

Why You’ll Love This Job

• Our Core Values:

• We are solution seekers.
• We have a can-do attitude.
• We are mission-driven.
• We care about people.

The Non-Medical Case Manager coordinates psychosocial support services for people living with HIV/AIDS. The case manager provides a range of client centered activities focused on improving access to and retention in needed core medical and support services the N-MCM provides coordination guidance and assistance in accessing medical social community legal financial employment vocation and/or other needed services. The N-MCM provides case management services at all agency locations, offsite locations within other community-based partner organizations, and curbside/home visits when needed.

The N-MCM conducts ongoing needs assessment monitors of care plans documents referring to outcomes to support patients towards self-sufficiency. The case management goal for each patient is to obtain viral suppression through a multi-team approach.

• Specific Responsibilities of the Job:

• Completes the HIV case management training series for case management annually.
• Completes patient needs assessment to identify unmet psychosocial services needs and determine a case management level/acuity for each patient on caseload.
• Obtains all requisite service eligibility documents, consent, and provides service coordination to support patient access to services.
• Maintains a caseload of patients with documented non-medical case management needs.
• Use the established acuity level and initiate ongoing and regular contact with each patient on caseload to determine needs that have been met, unmet, new needs, and barriers to care.
• Works with patients to develop a comprehensive care plan and set goals in collaboration with patients (including their authorized family, significant others, and other social service providers when appropriate), aimed at increasing the level of functioning and self-sufficiency.
• Performs psychosocial assessments to identify individualized needs in the areas of health, mental health, social support, addiction, financial resources, benefits, legal, language/culture, and employment.
• Provides appropriate and timely non-medical case management and referral follow-up with patients and document referral outcomes.
• Works collaboratively with medical, mental health, substance abuse, and community service providers as well as any authorized member of the patient’s care team.
• Maintains service continuity and eligibility by completing birth month and half birth month eligibility recertification.
• Documents and submit patients ready for case assignments to case management supervisors.
• Follow up with patients and authorized families to ensure that services provided are helpful, appropriate, and adequate.
• Identify emerging barriers and needs and help patients address concerns through problem solving, education, referrals, partnership, and advocacy.
• Regularly review patient’s level of involvement in case management, update care plans, and maintain patient contact in accordance with their level of case management needs.
• Supports patients and providers by reviewing and completing various eligibility forms for medications, social programs, and other funding sources, etc.
• Communicates with each client on a regular basis to determine which needs have been met and to identify any new needs.
• Follows established case management standards of care and agency procedures.
• Completes accurate and timely documentation of all clients encounters as required and submit all necessary reports to supervisor on time.
• Completes an encounter note and log to support patient services delivery daily as proof of daily case management services provided to patients.
• Advocates appropriate…