Case Manager, Early Intervention Program - Physician Practice

• Overview Our team members are the heart of what makes us better.
• At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed.
• With a culture rooted in connection and collaboration, our employees are team members.
• Here, competitive benefits are just the beginning.
• It’s also about how we support one another and how we show up for our community.
• Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
• Our team members are the heart of what makes us better.
• The Case Manager, Early Intervention Program provides clinical care coordination in conjunction with the healthcare providers and other support staff.
• Promotes prevention and health maintenance in an ambulatory care environment.
• Performs psycho-social assessment of the EIP patients and his/her family to determine and assist in resolving social, emotional and economic problems of the patient and the family.
• II.
• Age/Patient Population(s) served definition By providing assessment and treatment to patients ranging from adolescent, adult , to geriatrics, each job responsibility and competency measurement includes the requirement that employees in this position competency maintain and are evaluated on the skills to obtain and interpret information.
• Knowledge of growth and development and an understanding of the range of treatment needed as appropriate to the ages of those patients.
• Age of Patient Population Served: Adolescent (13-17 years) Adult (18-64 years) Geriartric (65+years).

Responsibilities

A day in the life of a Case Manager, Early Intervention Program at Hackensack Meridian Health includes: The individual must be able to fulfill the functions of medical case management as specified by the US Department of Health and Human Services, HIV/AIDS Bureau, and the Health Resources Service Administration (HRSA). Based on these guidelines, duties shall include the following: Initial assessment of health and related needs and development of a comprehensive, individualized service plan focused on health outcomes for each patient Involvement in the coordination and follow up of medical care in order to ensure timely and coordinated access to medically appropriate levels of health and support services and continuity of care. This shall include: Scheduling appointments for various treatments and referrals such as labwork, screenings, medical specialist appointments, mental health, oral healthcare and substance abuse Ensuring that patients are notified regarding appointments or rescheduling as needed Ensuring that patients have appropriate understanding of tests and/or procedures, documentation and transportation Ability to navigate the pre-certification process for tests and/or procedures independently Encouraging open dialogue with medical healthcare providers Provision of treatment adherence counseling and specialized health education in order to ensure readiness for and adherence to, complex antiretroviral therapy regimens for the treatment of HIV/AIDS Monitoring to assess the efficacy of service plans and periodic re-evaluation and adaptation of service plans as necessary Case Management Responsibilities: Performs psycho-social assessment of both patient and family. Acts as Case Manager for a minimum of 40 HIV+ patients Interviews patient/family/significant other to evaluate non-healthcare needs Actively collaborates with all team members to identify patient/family needs Assures timely documentation on the patients clinic chart all clinical issues and the psychosocial chart of all interventions, referrals and entitlement efforts Submits thorough monthly reports describing all activities and problems to the department head by the 5th of each month Serves as an educational resource to both RBMC employees and community agencies. Promotes culturally and linguistically appropriate educational programs to patients and community. Assist in the planning and implementation of community education and training programs Serves as an active member of community task forces, coalition and committees dealing with HIV/AIDS and its impact on the community Assumes responsibility for self-improvement and maintains current knowledge of trends and new developments in HIV/AIDS Attends hospital- based continuing education and programs on HIV/AIDS and other pertinent subjects Attends training and programs offered by outside agencies Attends and maintains CPR certification. Attends updates and refresher programs as required to keep certifications active Additional duties include Assisting with data collection and participating in quality assurance programs within the critical care program Active participation in weekly multidisciplinary meetings Routing medication related issues or inquiries to PharmD Facilitating non-emergency appointments Assisting with billing Other duties and/or projects as assigned. Adheres to HMH Organizational competencies and standards of behavior.