Hawai’i Health & Harm Reduction Center (HHHRC) provides harm reduction-focused services to marginalized populations in Hawai’i, including people living with and/or affected by HIV, hepatitis, substance use, homelessness, and the transgender, LGBQ, and the Native Hawaiian communities. HHHRC bridges gaps and helps individuals access essential resources such as housing, health care, entitlements, and treatment. We foster health, wellness, and systemic change in Hawai’i and the Pacific through outreach, care services, advocacy, training, prevention, education, and capacity building.
Primary Purpose
The HIV Medical Case Manager is responsible for providing client-centered medical case management services to clients living with HIV. This position delivers support and advocacy focused in the following areas: (1) medical & dental; (2) medication; (3) financial; (4) emotional & mental; (5) nutrition & food; and (6) housing. The HIV Medical Case Manager must work closely with clients, case management team, patient navigators, clinical staff, partner agencies, advocacy organizations, funders, and other resource providers to support positive client health and wellness outcomes.
Reporting Relationship
Reports to: Kauaʻi Services Coordinator
Supervises: N/A
Essential
Duties & Responsibilities
- Ensure clients are contacted.
- Contact clients in accordance with HHHRC standards for acuity level and document in e2 Hawaii and EMR.
- Meet with clients in or out of the office to address their needs.
- Ensure that all clients have access to medical and dental care.
- Confirm that all clients have health care coverage via Medicare, Medicaid, or their employer, including COBRA.
- Link clients to dental services via Waikiki Health (Makahiki Clinic), Queen’s Medical Center (QMC), or Department of Health (i.e., state dental).
- Refer clients to appropriate medical providers and provide medical transportation to appointments if client has no other means of transportation.
- Attend medical appointments if the client needs support and advocacy during an appointment.
- Link clients to applicable resources for HIV and other medications.
- Assist eligible clients in applying for HDAP or other drug assistance programs, if needed.
- Act as liaison between pharmacies and clients.
- Ensure that all clients are linked to medical care.
- Stay abreast of all current HIV treatment practices and work in conjunction with the community-based nurse.
- Conduct hospital visits for medically acute clients on consultative basis as needed.
- Establish and maintain relationships with local clinics and hospital facilities (e.g., Clint Spencer Clinic, Waianae Coast Comprehensive Health Center, Waikiki Health Center, Queens Medical Center, Kuakini Medical Center, Straub Medical Center, Castle Hospital, and Kahi Mohala) and HIV specialists.
- Monitor clients’ adherence to recommended medical care, including medications and doctor’s visits.
- Establish and maintain relationships with local prison facilities (e.g., Halawa, OCCC).
- Establish and maintain relationships with Hawaiʻi State Hospital.
- Ensure that all clients have access to all applicable financial benefits.
- Assist eligible clients in applying for Social Security Disability Insurance (SSDI).
- Assist eligible clients in applying for Supplemental Security Income (SSI), if needed.
- Assist eligible clients in applying for Department of Human Services’ (DHS) monetary benefits and Food Stamps, if needed.
- Assist eligible clients in applying for unemployment benefits, if needed.
- Assist eligible clients in applying for Ryan White emergency funding, if needed.
- Link clients with vocational rehabilitation programs (e.g., Social Security’s “Ticket to Work” program).
- Advocate on behalf of clients for Worker’s Compensation benefits, long-term disability, short-term disability, or temporary disability.
- Provide ongoing emotional support to all clients.
- Link eligible clients to psychiatric care services.
- Link clients to other mental health resources, if needed.
- Refer clients in crisis (e.g., suicidal) to appropriate resources.
- Provide counseling to clients considering re-entry into the workforce.
- Visit clients who are hospitalized or link them to the community-based nurse for intensive services.
- Ensure that all clients have access to nutritious food.
- Link clients to Food Basket and other meal programs, or other community resources.
- Link clients to Waikiki Health Center’s (WHC) nutritionist.
- Assist clients in accessing HHHRC food pantry, no more than once per month.
- Inform clients about meals served at HHHRC (i.e., Wednesday lunch) and at other community resources.
- Ensure that all clients have access to housing.
- Assist eligible clients to access emergency or temporary shelter.
- Assist eligible clients to obtain emergency funding for security deposits, rent, and utilities.
- Assist eligible clients to obtain furniture and household items from Laulima, Community Clearinghouse, or other resources.
- Advocate for clients during housing eligibility assessments (i.e., Gregory House).
- Act as liaison between clients and landlords.
- Assist eligible clients in navigating Section 8 application if/when Section 8 opens.
- Follow all administrative procedures/requirements.
- Document progress notes and batch entries/service deliveries for each and every phone and face-to-face and contact with clients in e2 Hawaii and Emed Practice (EMR) within 24 hours.
- Complete assessment within thirty (30) days of intake. Review care plan regularly. Revise care plan every six (6) months to determine eligibility.
- Initiate discharge procedures as needed.
- Recertify clients for HDAP every six (6) months to determine eligibility.
- Ensure hours worked are accurately recorded in ADP timekeeping system.
- Maintain reliable attendance and adhere to scheduled work hours.
- Attend and participate in meetings and supervisions as required and necessary.
- Perform other duties as needed and assigned. Duties are subject to change.
General Responsibilities
- Contribute to a safe, creative, enthusiastic, and cooperative working environment for all.
- Work as a team with other staff and support team members.
- Maintain appropriate professional and ethical standards while serving as a representative of HHHRC.
- Observe and comply with all rules and regulations – such as HHHRC Code of Conduct, Drug-Free Workplace – and other administrative policies of HHHRC.
- Abide by all policies and procedures of the HHHRC Health & Safety Program and the Quality Management Program.
- Comply with HHHRC confidentiality policy, HIPAA requirements, cultural competencies, and rights to persons served, as well as CARF standards.
- Demonstrate steadfast understanding of, and commitment to, the Mission, Vision, and Values of HHHRC.
Work Hours
- Monday –
- Friday, 8:00am to 4:30pm, with some evening and weekend attendance for required events.
Location
• 4370 Kukui Grove Street, suite 114&115, Lihue, HI 96766
Working Conditions/Physical Demands
Office environment: indoors, air conditioned.
Fieldwork: outdoors or indoors, may be subjected to unpredictable environments with extremes in temperature, noise, odors, weather conditions, etc.
Regular use of computer keyboards, telephone, and operating office equipment, requiring eye-hand coordination and finger dexterity.
Occasional lifting and carrying of supplies, equipment, files, documents, records, etc.
Long periods of time sitting using office equipment and computers.
Periods of standing and walking.
Requires possession of a reliable insured vehicle for traveling to off-site locations and for transporting participants.
Requires closed-toe shoes during working hours and comfortable and appropriate business-casual attire (walking shorts, and pertinent tee-shirt for scheduled activities/events of the day).
Required Qualifications
Knowledge/Skills/Abilities
- Willingness and ability to do outreach and engagement within communities of underserved populations, including but not limited to people living with and/or are affected by HIV, hepatitis, substance use, houselessness, and mental health challenges.
- Excellent interpersonal, written, and verbal communication skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
- Demonstrated ability to function as a team member, accept constructive criticism, and provide feedback and support.
- Ability to work well and thrive professionally in an atmosphere of significant diversity, working with marginalized populations.
- Good listening skills, non-judgmental, flexible, and able to handle complex situations/clients.
- Capability to self-regulate when experiencing triggers, trauma responses, or stressors to stay engaged, remain productive, and meet the needs of the team and clients.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, SharePoint, etc.).
Education/Experience
• Bachelor’s degree in Social Work (or comparable degree), or equivalent work experience.
Preferred Qualifications
- Master’s Degree in Social Work, and/or human services background.
- Familiarity with principles of harm reduction and the application of motivational interviewing techniques to support patient chronic disease case management.
Required Work Cards/Certifications
Valid Hawaii Driver’s License and clean three-year (3-year) Driver’s Abstract.
TB Clearance
Hep B Clearance and/or Vaccination
Must pass Center for Medicare/Medicaid Services eligibility screening.
Hawaiʻi Health & Harm Reduction Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
