Case Manager

Job Description

Job Description

Early Intervention Services is a HRSA funded program providing medical care and support for people living with HIV. The EIS Case Manager will work to improve, access to and retention in, needed core medical and support services for people living with HIV. The EIS Case Manager will also support the JPAFHC clinic system in providing client-centered services, HIV testing and counseling, care coordination, linkage to services and other needed social support services. The goal of the EIS Case Manager is to ensure timely and coordinated access to medically appropriate levels of care and support services for the patients we serve. The EIS Case Manager role supports all sites and required to commute to any of our sites as needed.

For patients at JPAFHC accessing care for HIV, the EIS Case Manager is responsible for supporting continuity of care through ongoing assessment of the clients, and other key family members’ needs and personal support systems to ensure linkage to appropriate services that helps patients becoming and staying HIV healthy.

Essential Duties and Responsibilities:

• Conduct HIV Testing (both internally and in the community), including Pre-test and Post-test counseling, to identify people who are living with HIV/AIDS to link them to care.
• Conduct initial pre-screening of clients to determine eligibility and appropriateness of case management services.
• Facilitate linkage to appropriate services for patients based on presenting problem
• Assist patients with the completion to required documentation from the center, such as M11Q’s, Home care forms, tax letters etc.
• Conduct risk reduction counseling, partner counseling and provide referral services with all clients in a status neutral approach.
• For patients living with HIV

For Patients Living with HIV:

• Complete client initial assessments and reassessments to develop a comprehensive care plan in collaboration with the patient that includes short and long-term goals focused on attaining and maintaining positive health outcomes.
• Re-evaluate care plan at least every 4-6 months with adaptations, as necessary.
• Refer and link patients to appropriate services within the system of care that promote positive health outcomes, treatment adherence, and greater self-sufficiency. Monitor to ensure patient’s successful linkage to services.
• Support the implementation of the medical treatment plan by providing health education, treatment adherence support (such as appointment reminders) and work to address any treatment adherence barriers.
• Participate in Viral Load Case Conferencing with patient’s care team to support care coordination, collaboration in addressing unsuppressed viral loads, lost to care, and barriers hindering patients in maintaining a healthy lifestyle.
• Evaluate effectiveness of services based upon client outcomes in the scope of work.

Minimum Qualifications

• Bachelor’s Degree in Human Services, Social Work or related field preferred, but equivalent community work experience and/or other certifications will be considered for exceptional candidates.
• At least 2 years case management experience preferred
• Experience in HIV, healthcare and/or social service settings preferred
• Computer literacy with proficiency in MS Word, Excel, and PowerPoint.
• Experience with Electronic Medical records preferred
• Demonstrated organizational, interpersonal, oral and written communication skills and the ability to handle multiple assignments at any time
• Comfort with working independently and collaboratively in a clinical environment
• Must have cultural competency and comfort working with LGBTQ, PLWH populations.
• Bi-lingual (English/Spanish) preferred.