Job Description

CAN Community Health is the nation's premier resource in ending epidemics with a mission of empowering wellness, has an exciting opportunity for a Medical Case Manager.

We are looking for someone who is passionate about serving the needs of individuals impacted by HIV, Hepatitis C, STI's, and other infectious diseases. You will become part of our professional team that drives home our Company's Mission and Values. We offer a good quality of life with an excellent daytime schedule, competitive pay with a bonus plan, premiere benefits package with a retirement plan with a generous company matching contribution. We have received recognition in 2025, 2024, 2023, 2022, 2021, 2019, & 2018 NPT's Best Non-Profit to Work for Award.

CAN is a Drug-Free Workplace. All potential hires will be required to take and clear a pre-employment drug screen upon job offer.

You can find out more about us by visiting our website at . Apply Today!

Salary: Starting at $50,000-$55,000 annually based on experience.

Must be able to pass a Level I background check (a Level II background may also be required).

CAN Community Health, Inc. is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Statement of Purpose: Provides outpatient HIV medical case management services and patient advocacy through education, counseling, advocacy, benefits assessment and enrollment, and coordination of services. Ensures patient access to essential medications, medical care, and support services.

Requirements

Primary Tasks:

1. Screen all clients for program eligibility, complete initial financial assessment and re-evaluation every 6 months to ensure continued eligibility.
2. Verify insurance coverage, assist in benefit applications, insurance prior authorizations, screening and referral for ADAP, ACA, Patient Assistance Programs or alternative coverage ensuring payor of last resort.
3. Development of a comprehensive, individualized care plan complete and a re-evaluation of this every 6 months.
4. Complete Initial assessment and acuity to determine service needs and re-evaluate every 6 months.
5. Provide referrals, linkage and coordination of services to community partners in accordance with local, state and federal program guidelines to promote goals of the individualized service plan.
6. Follow recommendation of care guidelines for medical case management services set forth by the Texas HIV Case Management Standards of Care.
7. Maintain compliance with the HIPAA privacy rule by following confidentiality standards and safeguarding the protected health information of patients.
8. Provide timely access to coordinated medically appropriate levels of services.
9. Submit timely and accurate monthly billing documentation and reports
10. Utilize the industry standards of best practice methods when providing services.
11. Ensure coordination of care and services by actively participating as a liaison on the patients clinical care team.
12. Maintain compliance with rules, laws and requirements set for by local, state and federal funding sources.
13. Ensure the integrity of case management records by effectively documenting all client encounters within the required software applications and auditing records routinely through the internal audit review process.
14. Maintain confidentiality regarding patient and/or family in accordance with professional standards and applicable laws.
15. Promotes and practice CAN Community Health, Inc.s mission and values, and follow policies and procedures set forth and approved by CAN Board of Directors.
16. Participate, actively engage and promote local HIV planning bodies.

Secondary Tasks:

1. Cross trains for effective team participation.
2. Develops and fosters networking relationships with community and support resources.
3. Participate in quality management activities.
4. Practices safety, environmental and/or infection control methods.
5. Continue professional training and education to advance knowledge and skills of HIV/AIDS.
6. Participates in continuous quality improvement of services rendered to CAN clients.
7. Utilizes resources and supplies in a cost-effective manner.
8. Demonstrates courtesy and respect in all interpersonal relationships with CAN clients, staff and visitors.
9. Maintains professional manner in all aspects of job tasks.
10. Performs all other duties as assigned.

Knowledge, Skills and Abilities Required:

1. Effective communication and interpersonal skills with patients, visitors and staff members.
2. Ability to utilize problem-solving techniques, a self-starter, work effectively, organized and perform multiple tasks simultaneously.
3. Ability to read, understand, follow and enforce safety procedures.
4. Demonstrates appropriate organizational skills.
5. Willingness to utilize computer software programs.
6. Accurately coordinate several tasks at one time.
7. Able to work with minimal direct supervision.
8. Must be able to travel to conferences, trainings, meetings, etc.

Education/Professional:

• Bachelors degree in a degree in health, human, or education services
• One year of case management experience with persons living with HIV and/or persons with a history of mental illness, homelessness, or chemical dependence.
• Consideration is given to those with experience in providing case management services to person living with HIV.

CAN Required Trainings:

General Orientation HIV/AIDS Violence in the Workplace

Sexual Harassment HIPAA Health Stream Courses (as assigned)

Basic Annual Safety Training

Texas DSHS Required Trainings:

Must be completed within 3 months of hire : 1. Effective Communication Tools for Healthcare Professionals 100: Addressing Health Literacy, Cultural Competency and Limited English Proficiency* 2. Texas HIV Medication Program 2013 Update* 3. HIV Case Management 101: A Foundation* 4. HIV Case Management 101: A Foundation Part Two (Module 1: HIV and Behavioral Risk; Module 2: Substance Use and HIV; Module 3: Mental Health and HIV)*

Must be completed within 9 months of hire : 1. STD Facts & Fallacies: Chlamydia, Gonorrhea & Pelvic Inflammatory Disease (PID)* 2. STD Facts & Fallacies: Syphilis* 3. Perinatal HIV Prevention Online Program*

*These courses are all available through the TRAIN (Training Finder Real-time Affiliate Integrated Network) Texas learning management system (

Must obtain 12 hours of CEUs in relevant core competency topics annually, examples of these are listed in the categories listed below. Texas DSHS will provide a of pre-approved training courses. Other topics not listed below may be used to fulfill the requirement; however, courses must be approved by DSHS and should be submitted prior to attending training

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