Medical Case Manager - Kaua'i

Hawai’i Health & Harm Reduction Center (HHHRC) provides harm reduction-focused services to marginalized populations in Hawai’i, including people living with and/or affected by HIV, hepatitis, substance use, homelessness, and the transgender, LGBQ, and the Native Hawaiian communities. HHHRC bridges gaps and helps individuals access essential resources such as housing, health care, entitlements, and treatment. We foster health, wellness, and systemic change in Hawai’i and the Pacific through outreach, care services, advocacy, training, prevention, education, and capacity building.

The HIV Medical Case Manager is responsible for providing client-centered medical case management services to clients living with HIV. This position delivers support and advocacy focused in the following areas: (1) medical & dental; (2) medication; (3) financial; (4) emotional & mental; (5) nutrition & food; and (6) housing. The HIV Medical Case Manager must work closely with clients, case management team, patient navigators, clinical staff, partner agencies, advocacy organizations, funders, and other resource providers to support positive client health and wellness outcomes.

Reports to:

Kauaʻi Services Coordinator

Supervises: N/A

• Ensure clients are contacted.

• Contact clients in accordance with HHHRC standards for acuity level and document in e2 Hawaii and EMR.
• Meet with clients in or out of the office to address their needs.

• Ensure that all clients have access to medical and dental care.

• Confirm that all clients have health care coverage via Medicare, Medicaid, or their employer, including COBRA.
• Link clients to dental services via Waikiki Health (Makahiki Clinic), Queen’s Medical Center (QMC), or Department of Health (i.e., state dental).
• Refer clients to appropriate medical providers and provide medical transportation to appointments if client has no other means of transportation.
• Attend medical appointments if the client needs support and advocacy during an appointment.

• Link clients to applicable resources for HIV and other medications.

• Assist eligible clients in applying for HDAP or other drug assistance programs, if needed.
• Act as liaison between pharmacies and clients.

• Ensure that all clients are linked to medical care.

• Stay abreast of all current HIV treatment practices and work in conjunction with the community-based nurse.
• Conduct hospital visits for medically acute clients on consultative basis as needed.
• Establish and maintain relationships with local clinics and hospital facilities (e.g., Clint Spencer Clinic, Waianae Coast Comprehensive Health Center, Waikiki Health Center, Queens Medical Center, Kuakini Medical Center, Straub Medical Center, Castle Hospital, and Kahi Mohala) and HIV specialists.
• Monitor clients’ adherence to recommended medical care, including medications and doctor’s visits.
• Establish and maintain relationships with local prison facilities (e.g., Halawa, OCCC).
• Establish and maintain relationships with Hawaiʻi State Hospital.

• Ensure that all clients have access to all applicable financial benefits.

• Assist eligible clients in applying for Social Security Disability Insurance (SSDI).
• Assist eligible clients in applying for Supplemental Security Income (SSI), if needed.
• Assist eligible clients in applying for Department of Human Services’ (DHS) monetary benefits and Food Stamps, if needed.
• Assist eligible clients in applying for unemployment benefits, if needed.
• Assist eligible clients in applying for Ryan White emergency funding, if needed.
• Link clients with vocational rehabilitation programs (e.g., Social Security’s “Ticket to Work” program).
• Advocate on behalf of clients for Worker’s Compensation benefits, long-term disability, short-term disability, or temporary disability.

• Provide ongoing emotional support to all clients.

• Link eligible clients to psychiatric care services.
• Link clients to other mental health resources, if needed.
• Refer clients in crisis (e.g., suicidal) to appropriate resources.
• Provide counseling to clients considering re-entry into the workforce.
• Visit clients who are hospitalized or link them to the community-based nurse…