Address
Form of workEIS Specialized Case Manager
POSITION SUMMARY
LRMC's EIS (Early Intervention Services) team aims to provide access to health care services and medication for persons living with HIV/AIDS (PLWHA) and to strengthen skills to achieve optimal treatment adherence with the goals of viral suppression and reduced HIV-related mortality.
The Ryan White Part B Specialized Medical Case Manager (SMCM) will be responsible for providing comprehensive case management services to persons living with HIV/AIDS, with a focus on assisting the PLWHA who have fallen out of or are sporadically engaged in HIV care and treatment overcome barriers preventing them from continuously engaging in care and treatment. The SMCM works with PLWHA/families/caregivers to identify and utilize the patient’s current personal strengths and empowers them to take charge of their care and build a plan that feels best suited to his/her individual need to assure overall health and wellness. The SMCM will also provide linkage to health care services, legal services, immigration, housing, government programs and mental health treatment. Additionally, the SMCM seeks to engage and expand support systems whenever possible for the PLWHA /families/caregivers.
To ensure SMCM availability to provide more intensive one-on-one services, the SMCM maintains a smaller caseload than traditional medical Case Managers. The SMCM’s caseload, however, fluctuates as PLWHA returns to care and others are successfully re-engaged and transitioned to less intensive, traditional medical case management.
WHY LRMC:
Little River Medical Center is a non-profit community health center within Horry County. At Little River Medical Center, we strive to offer exceptional health services and deliver quality, compassionate care to everyone. We provide a wide range of affordable health and support services for every family.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:
- The SMCM provides a range of services that link PLWHA/ /families/caregivers with medical care, psychosocial services, benefits, and other supportive services through:
- Assists the Outreach Specialist with contacts to PLWHA via telephone and conducting research to find updated contact information.
- Works closely with Outreach Specialists as PLWHA/patients are located and prepared to re-engage agency services and medical care.
- Interprets PLWHA/families/caregivers’ responses on barriers to care and treatment using statewide tool Return to Care Assessment (RTC).
- Customizes services through the development of an Enhanced Care Plan (ECP) with patient to re-align the PLWHA /families/caregiver’s perception/prior experience of service usefulness and accessibility barriers, allowing the patient to set service priority.
- Reviews and re-evaluates the ECP on a frequent basis, at a bi-weekly minimum.
- Emphasizes partner/families/caregivers /other support systems.
- Provides person centered, goal-oriented, time-specific Specialized Medical Case Management activities and support to encourage the patient’s participation in his/her own care plan.
- Identifies emerging barriers that may prevent each patient from maintaining participation in care and treatment.
- Coordinates and links patients to services required to implement the ECP.
- Monitors to assess the efficacy of the ECP, to include home/field visits as necessary.
- Enrolls and recertifies clients in SC ADAP (AIDS Drugs Assistance Program) and Affordable Care Act (ACA) as needed.
- Provides benefits counseling, support, and information, including risk reduction and service literacy expansion.
- Provides advocacy, referrals to and coordination with public or private programs, including hospitals, physicians, clergy, and community agencies to ensure continuity of care in the home or an institutional setting.
- Provides accurate and complete documentation of activity through Progress Logs, Services Provided, Enhanced Care Plan, and other project-specific data and evaluation collection methods in Provide Enterprise (PE).
- Maintains knowledge of community resources and methods to access services.
- Utilizes evidence-based, interviewing techniques, including but not limited to Motivational Interviewing, Trauma Informed Care, Basic Counseling, Health Literacy Expansion, etc.
- Attends necessary trainings/meetings, such as monthly outreach meetings at SC Department of Health and Environmental Control (SC DHEC) in Columbia, SC.
- Completes Medical Case Management required training within 18 months of hire.
- Assists PLWHA in referral and coordination with HOPWA (Housing Opportunities for People With HIV/AIDS) services on an as needed basis.
- Provide integrated healthcare services by sharing patient information in accordance with HIPAA regulations and Confidentiality laws within and outside LRMC to support an integrated and coordinated patient treatment plan.
- Takes time to explain the reasoning associated with program requirements, which will allow the PLWHA/families/caregivers to better understand service requirements and goal for patient to achieve undetectable viral load.
- Serve as a team member and provide team-based care to patients to improve communication and continuity of care.
- Ensure care coordination and transitions with patients/families/caregivers by tracking diagnostic tests, referrals, and care transitions to achieve high quality care coordination, lower healthcare costs, improve patient safety, and ensure effective communication with specialists and other providers.
- Other duties as assigned.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The qualifications 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.
- Knowledge and understanding of care management principles comma documentation comma referral processes comma and follow-up.
- Familiarity with regional HIV primary care, mental health, substance use treatment and other services and resources.
- Culturally responsive to individuals living with HIV/AIDS and those at-risk for becoming infected with the HIV, especially those who use injection drugs, immigrant, homeless and LGBTQIA+ populations.
- Possess an understanding of community level work and the importance of collaborating and coordinating with other organizations.
- Effective communication skills, including ability to follow instructions, listen, communicate effectively in writing and verbally; able to organize thoughts logically and explain clearly.
- Must be able to work a very flexible schedule including late hours and weekends.
- Be self- motivated and task oriented.
- Be able to develop and maintain supportive relationships with all patients and families that are affected by HIV/AIDS.
- Strong work ethic and reliable.
EDUCATION and/or EXPERIENCE
An HIV Medical Case Manager must meet one (1) of the following qualifications:
- Bachelor’s Degree from an accredited college or university in a human services field including, but not limited to, Social Work, Sociology, Health Education, Child and Family Development, Counseling, Psychology, or Nursing REQUIRED; or a master’s degree from an accredited college or university in a human services field including, but not limited to, Social Work, Sociology, Health Education, Child and Family Development, Counseling, Psychology preferred.
- Two (2) years’ experience working in the field of HIV/AIDS, behavioral health, substance misuse,
- Must meet training requirements as indicated by funding sources including completion of the Medical Case Management and Wavied Rapid HIV Testing trainings within 18 months of hire.
LRMC offers benefits such as:
- Medical, Vision & Dental insurance.
- Employer matched 403B Retirement Plan.
- Paid Vacation time, Sick time, & Holiday's. As well as paid qualifying Administrative Leave.
- Employer Paid Health Benefits: Life / AD&D Policies, Short/Long Term Disability, and a Employee Assistant Plan.
