Medical Policy Manager jobs in Fort Collins, CO

Description

Job Description

Position: Medical Case Manager

Classification: Non- Exempt

Reports to: Client Services Manager

Position Summary:

This full time, Medical Case Manager Position is responsible for providing individualized, comprehensive case management and advocacy services to people living with HIV/AIDS in the northern region of Colorado. This position requires some travel, reliable transportation, a valid driver’s license and current insurance is required.

Essential Job Functions:

• Provides intensive Case Management, based on levels of acuity, to a caseload of assigned clients.
• Process emergency financial requests
• Maintains ongoing, proactive contact to assess client’s physical and psychosocial status and needs through personal visits, telephone and written contacts.
• Conducts comprehensive intake and needs assessments to identify client needs, including but not limited to:
  • Access to healthcare and the client’s ability to self-manage and actively participate in healthcare
  • Adherence medication and medical treatment
  • Short term and long term housing needs
  • Income stability including employment needs and eligibility for public benefits (SSI, SSDI,Medicaid, Medicare, etc.)
  • Mental health and substance abuse issues using program specified assessment tools.
  • Food and nutrition
  • Risk reduction counseling
• Develops strategies and goals through Individual Wellness Plans, in conjunction with clients, to meet identified needs. Maintains timely Individual Wellness Plans according to program policies.
• Maintains quality and timely session documentation on all client interactions.
• Collects service eligibility documentation in a timely manner according to program policies.
• Assess caseloads on a monthly basis to determine client acuity. Inactivates cases based on services usage according to program policies.
• Collaborates and coordinates services with other HIV/AIDS service providers and community agencies.
• Identifies internal and external resources to meet client needs, and refers clients accordingly.
• Coordinates/Attends Case Conferences with CHN Housing Center, CHN Counseling Services, CHN Prevention Center, and other community providers as needed.

This list is not meant to be a comprehensive list of job duties. Other duties may be assigned.

Qualifications

Preferred Qualifications:
Oral and written fluency in English required. Multicultural experience highly preferred. Must be able to work in a diverse setting with diverse populations, including but not limited to sexual orientation. Background in programs related to affordable housing, sexual health, risk reduction, financial assistance, and other resource programs, especially as related to serving People Living with HIV. Training in culture competency/sensitivity is a plus. Experience working with federally funded programs.

Education:

Bachelor’s degree in Human Services, Social Work, Psychology, or related field preferred. Candidates with lived experience can substitute educational experience.

Software Utilized:

Experience working with basic office and database computer programs, including familiarity with Microsoft Outlook, Word, Excel, Access, SharePoint and the internet.

Knowledge, Skill and Ability:

Understanding of the Harm Reduction Model and Motivational Interviewing highly preferred. Skills in cultural competency/sensitivity. Excellent communication, client relations and management skills. Highly organized and detail oriented. This position requires personal and professional accountability; self-management and initiative; dedication to quality improvement, professional integrity and research ethics and cultural competency. Must demonstrate accuracy, efficiency and excellent organizational skills. Must demonstrate effectiveness in the following areas: task management; teamwork; time management; and communication with teams, managers, clients, and company consultants.

Material and Equipment Directly Used:

Works with standard office equipment including computer work station, printers, copiers, scanners and fax machine. Works with word processing software, spreadsheet applications, and presentation software. Communicates with clients and vendors using the telephone, e-mail, the Internet, and fax.

Physical Demands and Work Conditions:

Works in an office environment. Requires ability to lift up to 25 pounds of materials. Requires clear speaking ability and the ability to use a telephone for extended periods. Requires ability to view a computer screen (near acuity). Requires fingering agility for keyboarding and using a telephone and other office equipment.