Licensed Clinical Care Manager - ($7,500 Retention Bonus for LCSW/LMSW)

About the Role

A Licensed Clinical Care Manager contributes to AHF by utilizing their mental health expertise and understanding of the Ryan White Program. You will work collaboratively with patients, physicians, and the Healthcare Center team to address needs identified in the patient’s health and psychosocial Comprehensive Needs Assessment and implement an Individualized Care Plan. This includes providing education and assistance to ensure eligibility for the program is understood.

For Ryan White contracts combining psychosocial needs and resources within Medical Care Management, you will address mental health conditions or substance abuse patterns that interfere with a client’s ability to improve health and social outcomes. You will also understand basic needs such as housing, food, and clothing, develop relationships with relevant programs and agencies, and facilitate referrals and support for patients lacking these services.

You will conduct ongoing retention calls to ensure continuity of care and uphold radical cooperation across divisions. Your work will directly contribute to AHF’s success in meeting Ryan White contract deliverables and measures established by the HIV/AIDS Bureau (HAB) and the Department of Health and Human Services.

Responsibilities

• Screen clients for complex medical care and psychosocial issues requiring medical case management services.
• Establish Comprehensive Assessments, Individualized Care Plans, follow-ups, referrals, and guide clients through the spectrum of health and support services.
• Coordinate, follow up, and ensure completion of medical treatments and care plan interventions to provide timely and coordinated access to services.
• Verify client eligibility for the Affordable Care Act (ACA) program and enroll those who qualify.
• Advocate for AHF’s top initiatives while keeping the organization’s Core Values and Mission central to your work.
• Collaborate with providers to develop and monitor action or individual service plans, addressing patient needs, goals, and adherence to HIV/AIDS treatments.
• Monitor and document changing client needs through personal contact and review the care plan at least every six months.
• Provide brief interventions focused on long-term achievable goals, working with clients toward viral suppression, better health outcomes, and improved quality of life.
• Address barriers to care and treatment, supporting clients in taking all medications as prescribed.

Requirements

• Current and good standing Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW) in the jurisdiction where services are rendered.
• Minimum of 1 year of Case Management experience is preferred.
• Knowledge of Ryan White Services is preferable.