Medical Case Manager - Ryan White
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE…at AIDS Healthcare Foundation!
Does the idea of doing something that really makes a difference in people’s lives while being well compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you!
Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.
AHF’s core values are to be:
• Patient-Centered
• Value Employees
• Respect for Diversity
• Nimble
• Fight for What’s Right
STILL INTERESTED? Please continue!
Summary
The Ryan White (RW) RN Medical Case Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision case management services to patients of the AIDS Healthcare Foundation (AHF) Miami/Dade Healthcare Centers (HCCs)..
Key responsibilities include leading the case management team which provides culturally and linguistically sensitive cade management services to the HIV/AIDS patient population who are eligible for Ryan White services. The RNMCM assesses the patients and works collaboratively with the patients, their medical provider, designated family/significant others and community support service providers to address the needs identified in the patient’s health and psychosocial risk assessment and implement a plan of care based upon the needs identified. The RN MCM coordinates care planning, the scheduling of interdisciplinary team meetings, the identification of referral sources, provides referral an follow-up, oversight of the Peer Navigators, eligibility screening, and participates in activities that increase understanding of the communities served by the AHF HCCs. The RNMCM is responsible meeting the RW Medical Case Management Standards for Miami/Dade and for the patient specific health education, monitoring and deployment of techniques to assure the engagement and retention in care of the RW patients as well as their medication usage knowledge and adherence to antiretroviral (ARV) and chronic medication regimens goals are met.
Essential Duties & Responsibilities
Includes the following. Other duties may be assigned.
Maintains extensive knowledge regarding the current standards of HIV/AIDS care and case management processes.
Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management.
Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management.
Interviews patients and families to assess needs and risk categories to develop and implement appropriate plans of care and assessments
Establishes long and short term goals for the patient/family which are S-M-A-R-T
(Smart, Measurable, Achievable, Realistic, Timely)
Creates an individualized plan of action in collaboration with the patient, family, medical caregivers and community agencies.
Implements, monitors and evaluates the plan of care and its effectiveness. Revises as necessary.
Monitors hospital, emergency room, outpatient and ancillary services; lab values and patient satisfaction to determine program effectiveness.
Educates patients regarding the disease process and medications, methods for improving medication compliance, available community resources and other pertinent information.
Reviews medical records to identify needs and tracks outcomes. Updates plans of care (ISP) as required and as needed.
Performs reassessments as required by contractual requirements
Collaborates with ASO’s and other community services in the Eligible Metropolitan Area (EMA), including specialty care providers, as necessary to ensure appropriate access to services and follow-up on the results to such referrals.
Documents effectively in the PosiTrak computer system and tracks outcomes of care on an individual and aggregate basis regarding the patient and provider population.
Updates CareWare information as appropriate.
Maintains detailed record of time spent providing service to each patient and submits this information at regular intervals for timely billing.
Monitors patient’s acuity level in an ongoing fashion to ensure disenrollment when patient is no longer an acuity level that necessitates case management
Provides feedback to the referring provider regarding planned disenrollment from program.
Participates in local EMA functions in the community.
Assists in tracking, resolving and reporting of complaints/grievances.
Maintains information in a confidential manner.
Directs and monitors peer navigators activates to assist in returning members who have been lost to care.
Participation in AHF Meetings/Committees
Attends Meetings as required.
Supervisory Responsibilities
This job has no supervisory responsibilities.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed 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.
Education and/or Experience
Associate’s degree (A.A.) or equivalent from two-year College or technical school.
Language Skills
Ability to read, analyzes, and interprets general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Mathematical Skills
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent to draw and interpret bar graphs.
Reasoning Ability
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Computer/Software Skills & Abilities
To perform this job successfully an individual should have knowledge of MS Office Word, Microsoft Access, Microsoft Outlook, and Microsoft Excel s software, and Contact Management software a plus.
Certificates, Licenses and Registrations
Registered Nurse licensed by the State of Florida with an AS Degree; Baccalaureate Degree preferred.
Valid Florida Driver’s License with proof of automobile liability insurance.
Certification in case management preferred.
Other Skills and Abilities
Minimum one year managed care and case management experience.
Excellent written and verbal communication skills.
Excellent organizational skills.
Knowledge of ICD-9 Coding.
Clinical experience in the care of people with HIV/AIDS.
Must be able to travel 50% of the time.
If you are interested in this amazing opportunity, please CLICK HERE for immediate consideration.
Does the idea of doing something that really makes a difference in people’s lives while being well compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you!
Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.
AHF’s core values are to be:
• Patient-Centered
• Value Employees
• Respect for Diversity
• Nimble
• Fight for What’s Right
STILL INTERESTED? Please continue!
Summary
The Ryan White (RW) RN Medical Case Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision case management services to patients of the AIDS Healthcare Foundation (AHF) Miami/Dade Healthcare Centers (HCCs)..
Key responsibilities include leading the case management team which provides culturally and linguistically sensitive cade management services to the HIV/AIDS patient population who are eligible for Ryan White services. The RNMCM assesses the patients and works collaboratively with the patients, their medical provider, designated family/significant others and community support service providers to address the needs identified in the patient’s health and psychosocial risk assessment and implement a plan of care based upon the needs identified. The RN MCM coordinates care planning, the scheduling of interdisciplinary team meetings, the identification of referral sources, provides referral an follow-up, oversight of the Peer Navigators, eligibility screening, and participates in activities that increase understanding of the communities served by the AHF HCCs. The RNMCM is responsible meeting the RW Medical Case Management Standards for Miami/Dade and for the patient specific health education, monitoring and deployment of techniques to assure the engagement and retention in care of the RW patients as well as their medication usage knowledge and adherence to antiretroviral (ARV) and chronic medication regimens goals are met.
Essential Duties & Responsibilities
Includes the following. Other duties may be assigned.
Maintains extensive knowledge regarding the current standards of HIV/AIDS care and case management processes.
Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management.
Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management.
Interviews patients and families to assess needs and risk categories to develop and implement appropriate plans of care and assessments
Establishes long and short term goals for the patient/family which are S-M-A-R-T
(Smart, Measurable, Achievable, Realistic, Timely)
Creates an individualized plan of action in collaboration with the patient, family, medical caregivers and community agencies.
Implements, monitors and evaluates the plan of care and its effectiveness. Revises as necessary.
Monitors hospital, emergency room, outpatient and ancillary services; lab values and patient satisfaction to determine program effectiveness.
Educates patients regarding the disease process and medications, methods for improving medication compliance, available community resources and other pertinent information.
Reviews medical records to identify needs and tracks outcomes. Updates plans of care (ISP) as required and as needed.
Performs reassessments as required by contractual requirements
Collaborates with ASO’s and other community services in the Eligible Metropolitan Area (EMA), including specialty care providers, as necessary to ensure appropriate access to services and follow-up on the results to such referrals.
Documents effectively in the PosiTrak computer system and tracks outcomes of care on an individual and aggregate basis regarding the patient and provider population.
Updates CareWare information as appropriate.
Maintains detailed record of time spent providing service to each patient and submits this information at regular intervals for timely billing.
Monitors patient’s acuity level in an ongoing fashion to ensure disenrollment when patient is no longer an acuity level that necessitates case management
Provides feedback to the referring provider regarding planned disenrollment from program.
Participates in local EMA functions in the community.
Assists in tracking, resolving and reporting of complaints/grievances.
Maintains information in a confidential manner.
Directs and monitors peer navigators activates to assist in returning members who have been lost to care.
Participation in AHF Meetings/Committees
Attends Meetings as required.
Supervisory Responsibilities
This job has no supervisory responsibilities.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed 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.
Education and/or Experience
Associate’s degree (A.A.) or equivalent from two-year College or technical school.
Language Skills
Ability to read, analyzes, and interprets general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Mathematical Skills
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent to draw and interpret bar graphs.
Reasoning Ability
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Computer/Software Skills & Abilities
To perform this job successfully an individual should have knowledge of MS Office Word, Microsoft Access, Microsoft Outlook, and Microsoft Excel s software, and Contact Management software a plus.
Certificates, Licenses and Registrations
Registered Nurse licensed by the State of Florida with an AS Degree; Baccalaureate Degree preferred.
Valid Florida Driver’s License with proof of automobile liability insurance.
Certification in case management preferred.
Other Skills and Abilities
Minimum one year managed care and case management experience.
Excellent written and verbal communication skills.
Excellent organizational skills.
Knowledge of ICD-9 Coding.
Clinical experience in the care of people with HIV/AIDS.
Must be able to travel 50% of the time.
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