Hektoen Institute LLC
Corrections Medical Case Manager
Hektoen Institute LLC, Chicago, Illinois, United States, 60290
JOB SUMMARY
The Corrections Medical Case Manager (CMCM) will develop, implement, and evaluate a comprehensive, continuous care system for HIV positive and high-risk individuals recently released from the Cook County and Illinois Department of Corrections. The Corrections Medical Case Manager will provide a range of client-centered, confidential services that link clients with health care, clinical psychosocial, and supportive service for clients living with HIV/AIDS who are identified as having challenges with accessing and maintaining adherence to health care services. The Corrections Medical Case Manager will work closely with the CORE Center medical team to stabilize clients’ medically. They will facilitate linkage to and maintenance of clients to their primary medical services. The Corrections Medical Case Manager will also provide treatment adherence counseling to ensure readiness for, and adherence to complex HIV/AIDS treatments. The Corrections Medical Case Manager will assure that client is connecting to other core services; dental, Mental Health and Substance Abuse treatment. This case manager will also provide benefits counseling to clients and assist in enrollment, verification, and utilization of those benefits.
SPECIFIC RESPONSIBILITIES
Complete initial intake and assessment of needs on all new clients and clients returning to care.
If opened for Case Management services, complete AFC intake documentation.
Maintain an active case load of 25 clients with approved eligibility and updated care plans, meeting performance measure, and opening and closing clients as needed.
Make all initial referrals to educational programs, job readiness programs, Behavioral Health, Health education, dental, and benefits programs.
Assess benefits and complete necessary applications and referrals.
Maintain a caseload based on funder’s requirements.
Develop a comprehensive, individualized service plan.
Case Manager and client will agree upon goals and objectives for the services plan that will include specific outcomes with expected completion dates and timelines.
Case manager will conduct periodic re-evaluations at least once every 6 months review whether the goals were met and should continue or discontinue and/or make new goals if needed.
Case manager will collaborate with medical provider and other clinic staff to assure compliance with the service plan.
Maintain contact with client to assure Medical and Medication Compliance.
Case Manager will contact client prior to scheduled medical appointments to remind them of their appointment.
Case Manager will have a face-to-face contact with client monthly and have phone contact with client bi-weekly in between those face-to-face contacts.
Case Manager will conduct outreach if client becomes non-compliant by doing phone outreach, sending a letter to last known address, and complete home visits to encourage compliance with medical and medication.
Case Manager will advocate and reinforce education to client of the expectations of client around clinic appointments (ensuring client meets with CM at appointment), medication adherence and compliance to all referral to Substance Abuse and Mental Health Services.
Case Manager will identify barriers to appointments and provide support to encourage adherence. For example, the CM will access for transportation needs and provide transportation if needed.
Make appropriate and timely referral to internal and external providers and coordinate services identified on service plan.
Case manager will make referrals and document in electronic databases.
Follow-up on referrals will be made to provide necessary information and support to facilitate the referral.
Case Manager will meet with Medical Provider on a regular basis to mutually support client’s compliance with appointments.
Case manager will be present during clients scheduled medical appointments to advocate on client’s behalf for any identified or assessed services.
Case Manager will attend all pre-clinics to give updates on client’s social service needs and collaborate with other providers.
Complete a CM care conference with a licensed provider on all active clients at least once every 6 months.
Properly transition clients out of Corrections Medical Case Management into other appropriate programs.
Complete change of status after meeting all goals of the service plan and client deemed stable, transfer case into supportive case management or close.
If medically indicated, the client should refer to DRS services. The CM will maintain the client on their caseload until the client is accepted into the program.
Refer client to educational support groups if appropriate.
If client would like to transfer to another agency within the Case Management Cooperative, the appropriate transfer steps should be taken per AFC Standards of Procedure.
Adhere to Social Services Documentation Policy of all Patient Encounters and Forms.
Documentation of all face to face, phone calls, and collateral contacts must be in the Electronic Medical Record, and all other databases within 24 to 48 hours of interaction.
All client-related activities, referrals including approvals and denials should be in Patient Record and database.
All Data Entry and paperwork will be submitted in compliance with the policies.
All transportation, food vouchers, cabs, Uber rides must be properly documented including client’s signature of receipt.
Track any client or service trends and report in monthly supervision.
Maintain a Working Knowledge of Community and Internal program that would enhance the client’s ability to be maintained in care.
Attend any workshop that would familiarize case manager with community programs.
Keep a resource file of HIV/AIDS programs with contact information.
Be familiar with ADAP, CareLink, County Care, Medicare D programs and benefits programs that would benefit the clients.
Enhance Professional Development and Maintain an Area of Specialization
Discuss areas of specialization and interest with supervisor, seek and receive ongoing training in specialty area (corrections, community outreach, re-entry specific issues), periodically present cases or topics related to specialty area to case management department and/or social service staff.
Maintain professional competencies and complete at least 12 trainings per year.
Participate in all CORE Center and AFC mandatory training and meeting.
Complete and pass AFC Medical Case Management Certification within first 6 months of employment.
Complete and certify for the Anger Management Certification.
Attendance and certificate of completion for all trainings will go in employee’s record of all mandatory training. Any training that is missed should have supervisor’s approval.
Participate in Social Services Continuous Quality Improvement Efforts
Meet documentation requirements as outlined within the Social Services Department and throughout the CORE Center. Develop quality improvement processes as assigned.
Adhere to CORE Center and Social Services Specific Policies & Procedures
Provide Excellent Customer Service and Professionals when interacting with clients and internal and external customers.
Respond to phone calls, emails, faxes and pages in accordance with the CORE policies.
Maintain open communication with supervisors and communicate concerns through the appropriate means.
Other duties as assigned by Supervisor.
Provides clinic coverage/ on-call coverage/general coverage when a shortage arises.
QUALIFICATIONS – Knowledge/Skills/Experience Minimal Formal Education Required:
bachelor’s degree in social work or related field required.
Minimal Length & Nature of Experience Required:
Related internship up to 2 years preferred. Experience working in a hospital or out-patient setting preferred. Knowledge and experience working with diverse and complex clients preferred. Microsoft Office Program, Access, and similar database experience required. Experience working with clients with multiple needs. Comfortable working with high volumes of clients in a fast-paced environment preferred.
Licensure, Certification, Registration Preferred:
N/A
Special Knowledge and Skills Required and Preferred:
Bilingual preferred. Ability to function autonomously as a worker and as a team member on a multidisciplinary team, excellent oral and written communication skills, problem solving and conflict resolution skills. Knowledge of HIV/AIDS and family issues, commitment to confidentiality, ethics, and a culturally sensitive approach to counseling are required. Experience working in primary care medical settings desirable.
AGE-SPECIFICS (Patient Ages and Special Knowledge and Skills):
Depending upon assigned specialty area, understand and be aware of the differences in outreach/assessment approaches appropriate to different age groups—in order to provide effective services to CORE patients in terms of assessment, developmental understanding, communication and treatment modalities.
PHYSICAL DEMANDS/HAZARDS/ENVIRONMENTAL CONDITIONS
None EQUIPMENT Ability to use state of the art office tools (telephone voice mail, pagers, and computers used for service area documentation).
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The Corrections Medical Case Manager (CMCM) will develop, implement, and evaluate a comprehensive, continuous care system for HIV positive and high-risk individuals recently released from the Cook County and Illinois Department of Corrections. The Corrections Medical Case Manager will provide a range of client-centered, confidential services that link clients with health care, clinical psychosocial, and supportive service for clients living with HIV/AIDS who are identified as having challenges with accessing and maintaining adherence to health care services. The Corrections Medical Case Manager will work closely with the CORE Center medical team to stabilize clients’ medically. They will facilitate linkage to and maintenance of clients to their primary medical services. The Corrections Medical Case Manager will also provide treatment adherence counseling to ensure readiness for, and adherence to complex HIV/AIDS treatments. The Corrections Medical Case Manager will assure that client is connecting to other core services; dental, Mental Health and Substance Abuse treatment. This case manager will also provide benefits counseling to clients and assist in enrollment, verification, and utilization of those benefits.
SPECIFIC RESPONSIBILITIES
Complete initial intake and assessment of needs on all new clients and clients returning to care.
If opened for Case Management services, complete AFC intake documentation.
Maintain an active case load of 25 clients with approved eligibility and updated care plans, meeting performance measure, and opening and closing clients as needed.
Make all initial referrals to educational programs, job readiness programs, Behavioral Health, Health education, dental, and benefits programs.
Assess benefits and complete necessary applications and referrals.
Maintain a caseload based on funder’s requirements.
Develop a comprehensive, individualized service plan.
Case Manager and client will agree upon goals and objectives for the services plan that will include specific outcomes with expected completion dates and timelines.
Case manager will conduct periodic re-evaluations at least once every 6 months review whether the goals were met and should continue or discontinue and/or make new goals if needed.
Case manager will collaborate with medical provider and other clinic staff to assure compliance with the service plan.
Maintain contact with client to assure Medical and Medication Compliance.
Case Manager will contact client prior to scheduled medical appointments to remind them of their appointment.
Case Manager will have a face-to-face contact with client monthly and have phone contact with client bi-weekly in between those face-to-face contacts.
Case Manager will conduct outreach if client becomes non-compliant by doing phone outreach, sending a letter to last known address, and complete home visits to encourage compliance with medical and medication.
Case Manager will advocate and reinforce education to client of the expectations of client around clinic appointments (ensuring client meets with CM at appointment), medication adherence and compliance to all referral to Substance Abuse and Mental Health Services.
Case Manager will identify barriers to appointments and provide support to encourage adherence. For example, the CM will access for transportation needs and provide transportation if needed.
Make appropriate and timely referral to internal and external providers and coordinate services identified on service plan.
Case manager will make referrals and document in electronic databases.
Follow-up on referrals will be made to provide necessary information and support to facilitate the referral.
Case Manager will meet with Medical Provider on a regular basis to mutually support client’s compliance with appointments.
Case manager will be present during clients scheduled medical appointments to advocate on client’s behalf for any identified or assessed services.
Case Manager will attend all pre-clinics to give updates on client’s social service needs and collaborate with other providers.
Complete a CM care conference with a licensed provider on all active clients at least once every 6 months.
Properly transition clients out of Corrections Medical Case Management into other appropriate programs.
Complete change of status after meeting all goals of the service plan and client deemed stable, transfer case into supportive case management or close.
If medically indicated, the client should refer to DRS services. The CM will maintain the client on their caseload until the client is accepted into the program.
Refer client to educational support groups if appropriate.
If client would like to transfer to another agency within the Case Management Cooperative, the appropriate transfer steps should be taken per AFC Standards of Procedure.
Adhere to Social Services Documentation Policy of all Patient Encounters and Forms.
Documentation of all face to face, phone calls, and collateral contacts must be in the Electronic Medical Record, and all other databases within 24 to 48 hours of interaction.
All client-related activities, referrals including approvals and denials should be in Patient Record and database.
All Data Entry and paperwork will be submitted in compliance with the policies.
All transportation, food vouchers, cabs, Uber rides must be properly documented including client’s signature of receipt.
Track any client or service trends and report in monthly supervision.
Maintain a Working Knowledge of Community and Internal program that would enhance the client’s ability to be maintained in care.
Attend any workshop that would familiarize case manager with community programs.
Keep a resource file of HIV/AIDS programs with contact information.
Be familiar with ADAP, CareLink, County Care, Medicare D programs and benefits programs that would benefit the clients.
Enhance Professional Development and Maintain an Area of Specialization
Discuss areas of specialization and interest with supervisor, seek and receive ongoing training in specialty area (corrections, community outreach, re-entry specific issues), periodically present cases or topics related to specialty area to case management department and/or social service staff.
Maintain professional competencies and complete at least 12 trainings per year.
Participate in all CORE Center and AFC mandatory training and meeting.
Complete and pass AFC Medical Case Management Certification within first 6 months of employment.
Complete and certify for the Anger Management Certification.
Attendance and certificate of completion for all trainings will go in employee’s record of all mandatory training. Any training that is missed should have supervisor’s approval.
Participate in Social Services Continuous Quality Improvement Efforts
Meet documentation requirements as outlined within the Social Services Department and throughout the CORE Center. Develop quality improvement processes as assigned.
Adhere to CORE Center and Social Services Specific Policies & Procedures
Provide Excellent Customer Service and Professionals when interacting with clients and internal and external customers.
Respond to phone calls, emails, faxes and pages in accordance with the CORE policies.
Maintain open communication with supervisors and communicate concerns through the appropriate means.
Other duties as assigned by Supervisor.
Provides clinic coverage/ on-call coverage/general coverage when a shortage arises.
QUALIFICATIONS – Knowledge/Skills/Experience Minimal Formal Education Required:
bachelor’s degree in social work or related field required.
Minimal Length & Nature of Experience Required:
Related internship up to 2 years preferred. Experience working in a hospital or out-patient setting preferred. Knowledge and experience working with diverse and complex clients preferred. Microsoft Office Program, Access, and similar database experience required. Experience working with clients with multiple needs. Comfortable working with high volumes of clients in a fast-paced environment preferred.
Licensure, Certification, Registration Preferred:
N/A
Special Knowledge and Skills Required and Preferred:
Bilingual preferred. Ability to function autonomously as a worker and as a team member on a multidisciplinary team, excellent oral and written communication skills, problem solving and conflict resolution skills. Knowledge of HIV/AIDS and family issues, commitment to confidentiality, ethics, and a culturally sensitive approach to counseling are required. Experience working in primary care medical settings desirable.
AGE-SPECIFICS (Patient Ages and Special Knowledge and Skills):
Depending upon assigned specialty area, understand and be aware of the differences in outreach/assessment approaches appropriate to different age groups—in order to provide effective services to CORE patients in terms of assessment, developmental understanding, communication and treatment modalities.
PHYSICAL DEMANDS/HAZARDS/ENVIRONMENTAL CONDITIONS
None EQUIPMENT Ability to use state of the art office tools (telephone voice mail, pagers, and computers used for service area documentation).
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