Medical Policy Manager jobs in Barnstable, MA

The Medical Case Manager is a trained professional who works with people living with HIV to educate, plan, advocate and support them through the HIV medical and service system.

Essential Duties and Responsibilities:

• Provide one-on-one case management to people living with HIV to coordinate access to medical care and support services.
• Utilize Motivational Interviewing techniques to identify client motivation and address barriers to change.
• Complete client assessment and reassessment documents including the acuity scale.
• Serve as intake coordinator and first point of contact for new clients and referrals.
• Collect information from clients and complete appropriate paperwork and documents in assigned data systems.
• Develop a comprehensive care plan jointly with the client that includes short and long term goals focused on attaining, maintaining and achieving positive health outcomes.
• Refer and link clients to appropriate services within the system of care and monitor client access.
• Work as part of a multi-disciplinary team to aid and support the client’s service delivery plan and goals.
• Identify gaps in service delivery continuum and advocate for necessary services.
• Provide short-term health navigation services to appropriate clients as assigned.
• Maintain confidentiality to the full extent outlined in 42(C) FR part 2 regulations pertaining to the confidentiality of substance treatment records and 45 CFR Parts 160 & 164, the Health Insurance Portability and Accountability Act of 1996.
• Attend relevant training courses and participate in regional meetings as assigned.
• Stay informed about trends and developments in HIV service delivery, treatment, and substance use research.
• Other duties as required.

Education, Experience, & Skills

• Bachelor’s degree in social work or a related field preferred; and/or significant experience and training in the field of HIV, substance treatment, human services and/or related fields.
• Proven knowledge and experience of service delivery systems
• Organizational skills.
• Must be open to working with people from diverse backgrounds, cultures, and lifestyles in a non-judgmental manner. Sensitivity to HIV issues and people with disabilities required.
• Bilingual in Spanish or Portuguese preferred.

• 403B
• Dental insurance
• Disability insurance through Massaschusetts PFML
• Employee discounts, cell phone, eyewear etc.
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Flexible Spending Account
• Opportunties to earn CEU's
• Voluntary Benefits including Term and Whole Life, Accident, Critical Illness and Disability.