Medical Case Management Supervisor

About the role

PHMC serves as both a direct service provider and an intermediary agent, managing large-scale contracts, government and philanthropic partnerships, and multidisciplinary initiatives requiring operational sophistication, strategic leadership, and deep mission alignment. The Medical Case Management Supervisor oversees the staffing and performance of Medical Case Managers (MCM) and HIV/PrEP Patient Navigators across the PHMC Health Network.

Essential Duties and Responsibilities

• Provide leadership, oversight, and weekly supervision to the HIV Medical Case Managers and PrEP Patient Navigators.
• Serve as a spokesperson for the Medical Case Management program to DHH and speak confidently and accurately about MCM activities and workflows.
• Ensure compliance with all DHH and HRSA standards related to HIV Medical Case Management, HIV testing, and PrEP care coordination.
• Ensure staff maintain accurate and timely documentation of all client contacts (using D.A.P. format), forms, and applications in EHR software and in CAREWare.
• Conduct bi-weekly patient chart reviews and CAREWare audits to ensure documentation accuracy.
• Ensure all DHH training requirements for MCM Supervisors are met.
• Ensure MCMs and PrEP Patient Navigators complete all required internal and external trainings, and ensure all completed trainings are logged and reported to DHH.
• Conduct weekly individual supervision meetings with staff and accurately enter the corresponding service units into CAREWare.
• Ensure programmatic and reporting oversight of the Psychosocial Support Group.
• Collaborate with the interdisciplinary Health Network team in evaluating patient needs and treatment progress.
• Ensure coordination and collaboration of the MCM and PrEP Patient Navigator teams with other Health Network social service programs.
• Maintain a strong, up-to-date knowledge of community resources and public benefits.
• Serve as a liaison between pharmaceutical benefits programs, insurance plans, the PHMC Health Network, and/or patients regarding medical benefits, medical bills, billing questions, sliding fee schedule questions, and/or payment arrangements related to their medical care.
• Provide trauma-informed therapeutic support in collaboration with an interdisciplinary team, including crises.
• Perform analysis and reporting of MCM data as required by DHH.
• Keep abreast of all pertinent federal, state, DHH, and PHMC regulations, laws, and policies as they presently exist and as they change or are modified.
• Comply with HIPAA and Confidentiality Policies and Procedures as they apply to the job.
• Comply with Department of Public Health (DPH), The Joint Commission, and other accreditation and regulatory agencies' standards.
• Adhere to all PHMC Policies and Procedures.

Skills

• Bilingual/bi-cultural a plus.
• Exceptional leadership skills.
• Must be able to effectively communicate with patients, families, medical providers, insurance and pharmaceutical providers, and community partners.
• Exceptional ability to develop training and provide interdisciplinary education and instruction to staff and community partners.
• Strong ability to work with staff across disciplines.
• Strong data management and presentation skills.
• Strong time management and organizational skills.
• Must demonstrate sound judgement and initiative.
• Proficient with Microsoft Word, PowerPoint, and Excel.
• Comfort and flexibility working in a fast-paced health environment.
• Ability to work independently as well as in a team environment.

Experience

2 years of medical case management and/or PrEP care coordination experience required.

Education

Masters’ degree from an accredited university is required.
In lieu of a master's degree, 3 years of medical case management and/or PreP care coordination experience required, and a bachelor's degree in social work, psychology, or sociology, or related field.