Case Manager - Ryan White Program

Summary

Provides non-medical HIV/AIDS case management, patient education and prevention services to HIV

(+)/AIDS patients, including individualized case management and counseling. Assist patients with the

eligibility and enrollment procedure for various federal/state programs. Collect and maintain accurate

program data. Researches and approves claims related to medical care under the Ryan White program.

Make appropriate psycho-social and clinical referrals. This position is a support position necessary so

that clinic patients can have access to proper medical care, can monitor patient access to that care

regardless of their financial status. This position also helps ensure compliance with Ryan White law,

implements patient specific utilization of services and serves as a point of contact for patient billing

questions. Achieves operational objectives by contributing budgetary information and reviews, prepares

and completes action plans for resolving client financial problems, determining systems improvements

and meets financial activities by assisting with the annual budgets, reviewing expenditures, analyzing

variances and initiating corrective action plans.

Job Responsibilities:

• Uses variety of skills to evaluate and assist patients of the Center for Comprehensive Care of Immune Deficiency (C3lD) in overcoming barriers to proper treatment and management of their HIV disease.
• Is familiar with the current Virginia Department of Health HIV/AIDS Case Management Guidelines and provides at least minimum standard of care consistent with those guidelines.

• Provides periodic follow-up face-to-face and by telephone; although rare, occasional home visits may be required.
• Provides necessary linkages to government entitlements programs including Social Security Disability determinations, Medicaid, Medicare, Ryan White, AIDS Drug Assistance Programs (ADAP) and ACA that may include assistance in completing application forms and occasionally accompanying patients to respective appointments.
• Assist patients with maneuvering through the continuum of care. Provide support to empower clients to participate fully in their medical care and advocate for themselves.
• Collect, review, assist, and maintain appropriate financial and support documentation (i.e. co-pay bills) to support patient eligibility on periodic basis.
• Assist existing personnel to coordinate access to appropriate Levels of financial support services through collaborative and ongoing assessment of the client's financial status/needs, resulting in access to needed care.
• Regularly attends required modules, conferences and meetings during and after normal work hours to maintain high level of competence in relevant fields.
• Enter all patient demographics into CARE ware system, monthly encounters, case notes and other required data. Prepare grantee reports as necessary.
• Orients patients under case management to services available at C31D.
• Documents in a timely manner in chart form all of the patient encounters including the assessment, specific action expected of patient, necessary action of case manager, date of follow-up, etc.
• Provides in person assistance with education and enrollment services into the ACA plans. All services are provided in a culturally and linguistic appropriate manner.
• Provides confidential screening of referred patients by telephone or face-to-face encounters for eligibility under various entitlements programs.
• Performs other duties as assigned .
• Monitor client charges to ensure compliance with Ryan White requirements regarding imposition of charges for services.
• As necessary, conduct a periodic re-evaluation and adaptation of the plan.
• Ensure monthly entry of client level and service data, with all data entered by the 15th of the month following the completion of the month.
• Assist with implementing system to ensure a systematic ongoing process for entering current client level financial information into RW database.

Education and/or training:

• Bachelor’s degree in a relevant discipline and three (3) years of relevant experience required in human services- related field, such as social work, psychology, counseling, health services or education. Five (5) years’ experience preferred.
• Ryan White Program and/or HRSA Management experience strongly preferred.
• Prior grant management background is strongly preferred.
• Detail oriented
• Master’s degree preferred.

Level and type ofexperience

• Demonstrated experience directing complex programs.
• Strong working experience with grants and working with Federal, State, and local funding organizations/agencies.

• Demonstrated expertise in budget development, financial forecasting, and fiscal data analysis.

Specific knowledge, skills, and abilities:

• Significant Knowledge of Ryan White and/or HRSA Programs
• Ability to communicate effectively both orally and in writing.

• Advanced proficiency with Microsoft Excel.
• Experience with academic-community partnerships and training programs.
• Highly comfortable building and navigating complex formulas, pivot tables, data visualization, and financial modeling.
• Strong experience in billing audits, accounts reconciliation, or clinical data interpretation.