CAN Community Health is the nation's premier resource in ending epidemics with a mission of empowering wellness, and has an exciting opportunity for a Medical Case Manager.
We are looking for someone who is passionate about serving the needs of individuals impacted by HIV, Hepatitis C, STI's, and other infectious diseases. You will become part of our professional team that drives home our Company's Mission and Values. We offer a good quality of life with an excellent daytime schedule, competitive pay with a bonus plan, premiere benefits package with a retirement plan with a generous company matching contribution.
CAN is a Drug-Free Workplace. All potential hires will be required to take and clear a pre-employment drug screen upon job offer.
Salary: Starting at $50,000-$55,000 annually based on experience.
Must be able to pass a Level I background check (a Level II background may also be required).
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.
Responsibilities: Screen all clients for program eligibility, complete initial financial assessment and re-evaluation every 6 months to ensure continued eligibility.
Verify insurance coverage, assist in benefit applications, insurance prior authorizations, screening and referral for ADAP, ACA, Patient Assistance Programs or alternative coverage ensuring payor of last resort.
Development of a comprehensive, individualized care plan complete and a re-evaluation of this every 6 months.
Complete Initial assessment and acuity to determine service needs and re-evaluate every 6 months.
Provide referrals, linkage and coordination of services to community partners in accordance with local, state and federal program guidelines to promote goals of the individualized service plan.
Follow recommendation of care guidelines for medical case management services set forth by the Texas HIV Case Management Standards of Care.
Maintain compliance with the HIPAA privacy rule by following confidentiality standards and safeguarding the protected health information of patients.
Provide timely access to coordinated medically appropriate levels of services.
Submit timely and accurate monthly billing documentation and reports
Utilize the industry standards of best practice methods when providing services.
Ensure coordination of care and services by actively participating as a liaison on the patient’s clinical care team.
Maintain compliance with rules, laws and requirements set for by local, state and federal funding sources.
Ensure the integrity of case management records by effectively documenting all client encounters within the required software applications and auditing records routinely through the internal audit review process.
Maintain confidentiality regarding patient and/or family in accordance with professional standards and applicable laws.
Promotes and practice CAN Community Health, Inc.’s mission and values, and follow policies and procedures set forth and approved by CAN Board of Directors.
Participate, actively engage and promote local HIV planning bodies.
Requirements: 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, trainings, meetings, etc.
Education/Professional: Bachelor’s degree in a degree in health, human, or education services
One year of case management experience with persons living with HIV and/or persons with a history of mental illness, homelessness, or chemical dependence.
Consideration is given to those with experience in providing case management services to person living with HIV.
CAN Community Health, Inc. 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 without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.