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Form of workJob Description
Job Summary:
The incumbent is a member of an interdisciplinary team and is responsible for ongoing intervention and support to patient care and clinical initiatives. The Medical Case Manager (MCM) is responsible for enhancing the delivery of primary health care by facilitating appropriate utilization of medical services and by providing counseling, case management, referral services, benefit coordination, psychosocial assessment for patients and assistance to family and other supports.
Essential Functions:
Experience and Skills
Licenses and Certification:
Minimum Qualifications and Experience:
Core Competencies:
Job Benefits
Competitive Compensation package offered.
Job Summary:
The incumbent is a member of an interdisciplinary team and is responsible for ongoing intervention and support to patient care and clinical initiatives. The Medical Case Manager (MCM) is responsible for enhancing the delivery of primary health care by facilitating appropriate utilization of medical services and by providing counseling, case management, referral services, benefit coordination, psychosocial assessment for patients and assistance to family and other supports.
Essential Functions:
- Provides case management for targeted patient populations including people with HIV/AIDS, Hepatitis C, prenatal patients, and people with complex medical illnesses.
- Provides comprehensive counseling on a broad range of issues including basic health maintenance and preventive care, STD/HIV, conception and contraceptive use, prenatal care, options counseling and terminal illness coping/planning (advance directives, hospice care, etc.)
- Tracks patient Hepatitis C treatment schedule, ensuring necessary visits, diagnostics, medication pickups are completed.
- Assists with medication access matters and coordination with the 340b pharmacy and program manager.
- Maintains open communication with patients, periodically contacting to assess adherence and reporting pertinent findings to Providers.
- Maintains/oversees the CareLink Call Line, responding to patient texts and voice messages in a timely manner.
- Participates in offsite screening and patient care events, promoting Spectrum's offering, registering new Spectrum patients, scheduling appointments with Spectrum providers, and answering basic insurance questions.
- Assists all patients with HIV/AIDS to obtain SPBP for emergency medication coverage.
- Determines patients' eligibility for Medical Assistance, Wheels, SSI, TPAC, Special Pharmaceutical Benefits Program and other financial assistance programs and assists patients in obtaining benefits.
- Provides rapid HIV testing when required, education and prevention counseling.
- Provides individual and family support and referral as necessary to resolve emotional and psychosocial problems.
- Documents all patient contacts, case updates and referrals in the medical record according to established protocols and standards.
- Refers patients to community resources.
- Audits medical record outcomes related to area of expertise.
- Maintains current knowledge of pertinent financial issues for purposes of patient education, billing, and facilitating referrals.
- Prepares reports and audits requested by the supervisor.
- Coordinates organizational outreach and education activities to include community presentations and participation in health fairs as required.
- Serves on special committees and performs other duties as assigned.
Experience and Skills
Licenses and Certification:
- AACO AIDS/HIV pre-post test certification preferred.
Minimum Qualifications and Experience:
- Bachelor's degree in Social Work or other Social Sciences preferred
- At least one (2) year experience in case management or clinical experience in ambulatory healthcare
- An understanding of HIV disease and related clinical care
- Ability to maintain confidentiality of patient information at all times
- Cultural competence training for working with I.D. patient populations
- Knowledge of Word and EXCEL spreadsheet software applications required
- Knowledge in accessing and using the Internet required
- Automobile and current driver license preferred
- Ability to be flexible and work at all center locations as required.
Core Competencies:
- Interpersonal skills and communication
- Medical Knowledge
- Systems based practice
- Practice Based learning and improvement
- Patient Care and Professionalism
Job Benefits
Competitive Compensation package offered.
