RN Medical Care Manager

About the Role

The RN Medical Care Manager (MCM) blends the mission of AHF with Medical Case Management, utilizing their experience, skills, and education together with a thorough understanding of the Ryan White Care Act Program. You will work with providers and the healthcare center team to ensure every Ryan White patient receives the support they require and access to available resources.

This role involves providing education and assistance to help patients understand their eligibility for the program. Working directly within the Healthcare Center, you will meet with patients to complete Health Risk/Needs Assessments, develop Service/Action/Care Plans, and provide ongoing education about diagnoses and medications.

For Ryan White contracts that include psychosocial needs within Medical Case Management, you will address mental health needs and basic needs such as housing, food, and clothing. You will develop relationships with programs and agencies serving these needs and facilitate referrals, support, and assistance for patients lacking those services.

Using your case management experience, you will meet patients where they are, identify strengths and opportunities for growth, and assist them with realistic goal setting. Your collaboration and engagement skills will bring the essence of the Ryan White Care Act—a safety net for uninsured HIV/AIDS patients—to our most vulnerable population.

Your work will directly contribute to AHF’s success in meeting the deliverables of our Ryan White contract, as well as measures established by the HIV/AIDS Bureau (HAB) and the Department of Health and Human Services. The MCM often serves as the liaison between provider and patient, facilitating the transition from the exam room to implementing an optimum plan of care.

Through brief interventions focused on long-term achievable goals, you and the patient will work together toward viral suppression, better health outcomes, and improved quality of life.

Responsibilities

• Complete Health Risk/Needs Assessments for patients.
• Develop Service/Action/Care Plans in collaboration with patients.
• Provide ongoing education to patients about their diagnoses and medications.
• Assist patients in understanding their eligibility for the Ryan White Care Act Program.
• Address psychosocial needs, including mental health, housing, food, and clothing.
• Develop relationships with programs and agencies to facilitate referrals and support for patients.
• Identify patient strengths and opportunities for growth, assisting with realistic goal setting.
• Serve as a liaison between providers and patients to implement optimal care plans.
• Work with patients toward viral suppression, better health outcomes, and improved quality of life.
• Contribute to AHF’s success in meeting Ryan White contract deliverables and HAB measures.

Requirements

• Valid California RN License.