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Medical Case Manager

Company: CAN Community Health
Location: Sarasota
Posted on: October 19, 2020

Job 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.Primary Tasks: Medical Case Manager

  • Screen all clients for program eligibility, completes biannual reassessments for eligibility enrollment.
  • Verifies insurance coverage and coordinates the necessary pre-authorizations.
  • Develops, coordinates and implements individual plans of care biannually.
  • Provide referrals, linkage and coordination of services to community partners in accordance with local, state and federal program guidelines.
  • Responsible for Ryan White, HOPWA and ADAP Premium Plus case management and all other case management assignments.
  • Provides access to case management services in a variety of confidential locations including the clinic and patients' home.
  • Ensures the integrity of case management records through the audit review process.
  • Accurately document all client encounters within software applications.
  • Submit timely and accurate monthly billing documentation and maintains client case management files.
  • Processing needed paperwork for Patient Assistance Program.
  • Complies with all program requirements as well as up to date with all changes of the programs.
  • Collaborates with clinic team members to coordinate patient services.
  • Processes documentation required by state and local funding sources as required.
  • Maintains confidentiality regarding patient and/or family in accordance with professional standards and applicable laws.
  • Promotes and practices CAN Community Health, Inc.'s mission and values, and follows its policies and procedures.
  • Ensures confidentiality is maintained by case management team regarding patient/client information in accordance with HIPAA, professional and departmental standards.Secondary Tasks: Medical Case Manager
  • Cross trains for effective team participation.
  • Develops and fosters networking relationships with community and support resources.
  • Practices safety, environmental and/or infection control methods.
  • Continues professional training and education to advance knowledge and skills of HIV/AIDS.
  • Participates in continuous quality improvement of services rendered to CAN clients.
  • Utilizes resources and supplies in a cost-effective manner.
  • Demonstrates courtesy and respect in all interpersonal relationships with CAN clients, staff and visitors.
  • Maintains professional manner in all aspects of job tasks.
  • Performs all other duties assigned.Reports To: Director of Case Management.

    Knowledge, Skills and Abilities Required: Medical Case Manager
  • Effective communication and interpersonal skills with patients, visitors and staff members.
  • Ability to utilize problem-solving techniques, a self-starter, work effectively, organized and perform multiple tasks simultaneously.
  • Ability to read, understand, follow and enforce safety procedures.
  • Demonstrates appropriate organizational skills.
  • Willingness to utilize computer software programs
  • Accurately coordinate several tasks at one time.
  • Able to work with minimal direct supervision.
  • Must be able to travel to conferences, training sessions, meetings, etc.Education/Professional: Medical Case Manager
  • Bachelor's degree from an accredited school or equivalent experience in social services.
  • HIV prevention and intervention experience.Physical Demands: Medical Case Manager
  • Neat, professional appearance.
  • Exerts up to 10 lbs. of force frequently, and/or a negligible amount of force 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.
  • Requires expressing or exchanging ideas by means of spoken word, visual and auditory acuity.Work Environment: Medical Case Manager
    • This job operates in a professional office environment. This role routinely uses standard office equipment such as computers and various software programs, telephones, photocopiers, filing cabinets and fax machines.Position Type/Expected Hours of Work: Medical Case ManagerThis position may require overtime during peak periods.Other Duties: Medical Case ManagerPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of an employee of this job. Duties, responsibilities and activities may change at any time with or without notice.CAN is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. PI124269702

Keywords: CAN Community Health, Sarasota , Medical Case Manager, Healthcare , Sarasota, Florida

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