Medical Case Management Supervisor

The Medical Case Management Supervisor shall oversee the staffing and performance of Medical Case Managers (MCM) and HIV/PrEP Patient Navigators across the PHMC Health Network. This person shall possess a strong knowledge of Philadelphia Division of HIV Health (DHH) Medical Case Management and PrEP standards and shall serve as a liaison to DHH around MCM activities. The Medical Case Manager Supervisor will ensure that regular, ongoing, and high-quality supervision is provided and appropriately documented and that all staff are connected to and complete all required trainings. The Medical Case Manager Supervisor will additionally ensure that the team, and the patients it serves, are connected to programs, which specifically support people living with HIV. They will also ensure that they, the Medical Case Managers, and the PrEP Patient Navigators are full trained on and aware of broader, non-HIV-specific community resources and are know how connect patients to these services. Lastly, this person will serve as a liaison between pharmaceutical benefits programs, insurance plans, the PHMC Health Network, and/or the patients regarding medical benefits, medical bills, billing questions, sliding fee schedule questions and/or payment arrangements related to their medical care.
AGE/PATIENT POPULATIONS SERVED (Double-click on box to activate appropriate indicator)
Age of Patient Population Served Pediatric (birth - 19 yrs) Adult (19 - 64 yrs) Geriatric (65 yrs & older) Nonage Specific Task (N/A) Population Bariatric Patients: BMI greater than 40, or greater than 35 with weight related comorbidities Patient with exceptional communication needs Patient with developmental delays Patient at the end of life Patient under isolation precautions All Populations
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Provide leadership, oversight, and weekly supervision to the HIV Medical Case Managers and PrEP Patient Navigators.
• Serve as a spokesperson for the Medical Case Management program to DHH and be able to speak to MCM activities and workflows confidently and accurately.
• Ensure compliance with all DHH and HRSA standards related to HIV Medical Case Management, HIV testing, and PrEP care coordination.
• Ensure that staff maintain accurate and timely documentation of all client contacts (using D.A.P. format), forms, and applications in EHR software and in CAREWare.
• Conduct bi-weekly patient chart reviews and CAREWare audits to ensure documentation accuracy.
• Ensure all DHH training requirements for MCM Supervisors are met.
• Ensure MCMs and PrEP Patient Navigators complete all required internal and external trainings, and ensure all completed trainings are logged and reported, as needed, to DHH.
• Conduct weekly individual supervision meetings with staff and accurately enter the corresponding service units into CAREWare.
• Ensure programmatic and reporting oversite of the Psychosocial Support Group.
• Collaborate with the inter-disciplinary Health Network team in the evaluation of patient needs and treatment progress.
• Ensure coordination and collaboration of the MCM and PrEP Patient Navigator teams with other Health Network social service programs.
• Maintain a strong, up-to-date knowledge of community resources and public benefits.
• Serve as a liaison between pharmaceutical benefits programs, insurance plans, the PHMC Health Network, and/or the patients regarding medical benefits, medical bills, billing questions, sliding fee schedule questions and/or payment arrangements related to their medical care.
• Provide trauma-informed therapeutic support in collaboration with interdisciplinary team, including crisis situations.
• Perform analysis and reporting of MCM data as required by DHH.
• Perform other duties as assigned.
• Keeps abreast of all pertinent federal, state, DHH, and PHMC regulations, laws, and policies as they presently exist and as they change or are modified.
• Comply with HIPAA and Confidentiality Policies and Procedures as they apply to the job.
• Comply with Department of Public Health (DPH), The Joint Commission and other accreditation and regulatory agencies standards.
• Adhere to all PHMC Policies and Procedures.
SKILLS:
• Bilingual/bi-cultural a plus.
• Exceptional leadership skills.
• Must be able to effectively communicate with patients, families, medical providers, insurance and pharmaceutical providers, community partners.
• Exceptional ability to develop trainings and provide interdisciplinary education and instruction to staff and community partners.
• Strong ability to work with staff across disciplines.
• Strong data management and presentation skills.
• Strong time management and organizational skills.
• Must demonstrate sound judgement and initiative.
• Proficient with Microsoft Word, Power Point and Excel.
• Comfort and flexibility working in a fast-paced health environment.
• Ability to work independently as well as in a team environment.
EXPERIENCE:
• 2 years Medical Case Management and/or PrEP care coordination experience required.
EDUCATION REQUIREMENT:
• Masters' degree from an accredited university is required, or 3 years Medical Case Management and/or PrEP care coordination experience required, in lieu of masters' degree.
PHYSICAL DEMANDS:
• Travel is occasionally required by personal automobile or public transportation.
• Walking from public transportation is required.
• Stair climbing may be required.
• Carrying client charts and forms and setting up for psychosocial groups is required.
• Position may additionally require standing or climbing stairs 1/5 of the time, walking 1/3 of the time, sitting 3/5 of the time, use of hands 2/3 of the time, reach with hands and arms 1/3 of the time, and talk and hear over 2/3 of the time.
WORK ENVIRONMENT:
• Moderate noise (examples: business office with computers and printers, light traffic).
• Shared work environment.
• Primary work environment is a medical facility, with a degree of exposure to tuberculosis and other air-borne disease that may require the use of personal protective equip