Essential Job Responsibilities

Team Building

Coordinates the hiring, training, competency assessment and supervision of assigned staff.

Coordinates with other departments and coordinates with other agencies as necessary to facilitate the delivery of all types of Case Management and other assigned services.

Maintains relationships by representing the agency with assigned community groups and organizations at the local and state levels to ensure coordinated service delivery.

Assists the director with marketing and promotional activities of the programs.

Quality Assurance and Performance Improvement

Establishes as appropriate clinical and administrative procedures required for high quality, effective Case Management at the agency and for other staff as applicable ensuring compliance with all standards of care.

Performs an assigned number of Quality Assurance and record reviews directly for Case Management and other assigned services.

Develops and coordinates the identification, organization and assessment of resources for Medical Case Management, Medicaid/Medicare and privately insured Case Management and other assigned services.

Responsible for coordinating and managing site visits, monitoring visits, and audits from funders and ensures performance of staff meets established standards to receive positive results.

Prepares charts for internal and external audits.

Ensures areas of responsibility adhere to HIPAA and other State, Federal and Local regulations, standards of care and QA measures.

Manages all improvement of services in assigned areas through utilizing Plan, Do, Check Act Cycle and Every time Checklists.

Utilization Review

Completes monthly productivity reports for assigned programs, reports on deliverables and acts upon emerging problem areas to increase appropriate utilization.

Coordinates reviews and monitors all billings, budgets and contracts related to Case Management and other assigned services.

Ensures all documentation and billing is accurate, timely, legible and complete.

Ensures productivity is equitably, reasonably and regularly produced by each person within the areas assigned according to the following guidelines:

Medical Case Managers (Productivity equals 444 units per month, with active monthly caseloads of 80-100)

Housing Case Managers (Productivity equals 444 units per month, with active monthly caseloads of 80-100)

FQHC Medical Case Managers (Productivity equals 444 units per month, with active monthly caseloads of 80-100)

Adult Targeted Case Managers (bill on average 6 hours per day)

Intake Assistants (Productivity equals 444 units per month with cases assigned according to need)

Programmatic Development and Support

Maintains regularly scheduled meetings with staff, logging minutes into electronic records including Ryan White Part A, MAI, and Care Resource files.

Coordinates all training for those within assigned areas by maintaining records of agendas, training materials, attendance, and certificates of completion for all formal training.

Responsible for the billing, control, and reporting of monthly bus passes.

Participates in grant writing and contract management for the programs.

Develops reviews and maintains relevant policies and procedures at a minimum yearly.

Culture of Service: 3 C’s

Compassion

• Greets internal or external customers (i.e. patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone, and nonverbal language.

• Listens to the internal or external customer (i.e. patient, client, staff, vendor) attentively, reassuring, and understanding of the request and providing appropriate options or resolutions.

Competency

• Provides services required by following established protocols and when needed, procure additional help to answer questions to ensure appropriate services are delivered

Commitment

• Takes initiative and anticipates internal or external customer needs by engaging them in the process and following up as needed

• Prioritize internal or external customer (i.e. patient, client, staff, vendor) requests to ensure the prompt and effective response is provided

Safety

Ensures proper handwashing according to the Centers for Disease Control and Prevention guidelines.

Understands and appropriately acts upon the assigned role in Emergency Code System.

Understands and performs assigned roles in the organization’s Continuity of Operations Plan (COOP).

Contact Responsibility:

The responsibility for internal and external contacts is frequent and important.

Physical Requirements:

This work requires the following physical activities: constant sitting, walking, and hearing, talking in person, and talking on the phone. Occasional driving stretching/reaching and standing are required. Work usually performed in an office setting.

Other

Participates in health center developmental activities as requested.

Other duties as assigned.

Experience

Required

• 4 year(s): At least four years of case management experience with HIV/AIDS service provider organizations or healthcare provider is preferred. At least three years of quality management experience in social services or healthcare environment preferred. At least three years of supervisory experience are required.

Education

Required

• Bachelors or better in Nursing or related field
• Bachelors or better in Social Work or related field

Preferred

• Masters or better in Social Work or related field
• Masters or better in Health Administration or related field

Licenses & Certifications

Required

• ACA Certified
• Application Counselor
• Medicaid Provider Cert

Preferred

• Cert Registered Nurse
• Licensed Practical Nurse
• LCSW

Skills

Required

• Phone etiquette
• Microsoft Office
• Windows
• Team Management
• Delegation
• Conceptual Thinking
• Decision Making
• Critical thinking
• Customer Service
• Confidence
• Commitment
• Collaboration
• Bilingual (English-Spanish)
• Conflict Resolution
• Analysis
• Acknowledging Others
• Active Listening
• Achievement

Behaviors

Required

• Team Player: Works well as a member of a group
• Leader: Inspires teammates to follow them
• Enthusiastic: Shows intense and eager enjoyment and interest
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
• Dedicated: Devoted to a task or purpose with loyalty or integrity

Motivations

Required

• Goal Completion: Inspired to perform well by the completion of tasks
• Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals
• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization