Medical Case Manager
Listed on 2026-02-27
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Healthcare
Community Health, Healthcare Administration
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. Bachelor’s degree from an accredited school or equivalent experience in social services, education, public health, or social work is required.
Primary Tasks:
1. Screen all clients for program eligibility, completes annual reassessments for referrals to Central Eligibility.
2. Verifies insurance coverage and coordinates pre-authorizations.
3. Develops, coordinates and implements individual plans of care biannually.
4. Provide referrals, linkage and coordination of services to community partners in accordance with local, state and federal program guidelines.
5. Responsible for Ryan White, HOPWA and ADAP case management and all other case management assignments.
6. Ensures the integrity of case management records through the audit review process.
7. Accurately document all client encounters within software applications such as CAREWare or Provide Enterprise.
8. Submits timely and accurate monthly billing documentation and maintains client case management files.
9. Processing paperwork for Patient Assistance Program, as needed.
10. Complies with all program requirements as well as up to date with all changes of the programs.
11. Collaborates with clinic team members to coordinate patient services.
12. Processes documentation required by state and local funding sources as required.
13. Maintains confidentiality regarding patient and/or family in accordance with professional standards and applicable laws.
14. Promotes and practices CAN Community Health, Inc.’s mission and values, and follows its policies and procedures.
15. Ensures confidentiality is maintained by case management team regarding patient/client information in accordance with HIPAA, professional and departmental standards.
16. Exerts up to 10 lbs. of force frequently, and/or a negligible amount of force frequently or constantly in lift, carry, push, pull, or otherwise move objects, including the human body. Involves sitting most of the time but may involve walking or standing for brief periods of time.
Requirements
Knowledge, Skills and Abilities Required:
1. Effective communication and interpersonal skills with patients, visitors and staff members.
2. Ability to utilize problem-solving techniques, a self-starter, work effectively, organized and perform multiple tasks simultaneously.
3. Ability to read, understand, follow and enforce safety procedures.
4. Demonstrates appropriate organizational skills.
5. Accurately coordinate several tasks at one time.
6. Able to work with minimal direct supervision.
7. Must be able to travel to conferences, trainings, meetings, etc.
CAN Required Trainings:
General Orientation, HIV/AIDS, Sexual Harassment, HIPAA, Health Stream Courses (as assigned)
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