Ryan White Medical Case Manager

Working title: Ryan White Medical Case Manager                  Position #(s):

Classification title: Case Manager

Division: Client Health Services                           Program: HIV Services

Class category:                                                      UKG Project Code:

FLSA status: Non-Exempt:                               UKG Cost Category Code:

Reports to: HIV Services Manager                      Date revised: March 2025

Organizational Overview

Serving the Yellowstone County community and south-central Montana for nearly 50 years, RiverStone Health is an essential provider of personal and public health services. Health, Education, Leadership and Protection – HELP is what we do. From medical, dental, and behavioral healthcare; home care and hospice; public health services like immunizations, WIC, health promotion and restaurant inspections; and educating the next generation of health professionals, our expertise spans all ages and stages of life. Underlying principles of access, affordability, compassion, and quality in all interactions, RiverStone Health improves life, health, and safety for all of the communities we serve.

Job Summary:

The Ryan White Medical Case Manager plays a crucial role in supporting individuals living with HIV by ensuring they receive comprehensive care and remain engaged in treatment. Operating within the framework of Ryan White Standards of Care and grant deliverables, this position involves assessing client needs, creating a plan of care to meet client’s concerns and needs, addressing inquiries, and referring to community resources. This is a grant funded program and which is subject to annual renewal.

Essential Functions/Major Duties and Responsibilities:

A.   Case Manager Services                                                               50%

• Promote RiverStone Health programs to eligible individuals.

• Maintain up to date patient charts, progress notes, care plans and other related medical information.

• Provide patient guidance through financial assistance, and additional RiverStone Health services to ensure clients are receiving a full array of services available to them.

• Review and submit client request for financial assistance.

• Produce, maintain, and submit regular data and program reports for grant and other reporting requirements.

• Participate in and attend meetings, conferences workshops and training sessions to become and remain current on the principles, practices and new developments in the program field.

• Participate in and provide audit data.

• Assist in the development of annual work plans and quality improvement projects.

• Respond to communications in a courteous and timely manner.

• Perform work with the strict knowledge and understanding of protected sensitive patient health information (HIPAA) and confidentiality.

• Interview and gather health information using interpersonal and cultural sensitivity skills.

• Respond to questions and comments in a courteous and timely manner.

• Participate in emergency preparedness trainings, exercise and response activities.

• Participate in program quality improvement projects.

• Attend meetings, conferences, workshops and training sessions to become and remain current in the principles, practices and new development in assigned work areas.

B.     Ryan White Services                                                                          45%

• Screen and enroll eligible HIV positive clients into Ryan White service

• Coordinate medical, dental, substance abuse and mental health services for Ryan White clients with local providers to assure continuity of care is accomplished across the spectrum of care.

• Facilitate signing of Ryan White paperwork with all providers of care.

• Participate in program QI projects.

• Provide face to face and/or telephone case management for all Ryan White patients to assess the client’s current medical status, such as medication compliance, nutritional issues, dental needs, mental health/substance abuse issues, and financial program assistance.

• Enter current medical and demographic data for all Ryan White patients into eCW.

• Provide referrals to community resources (i.e., Medicaid, AIDS Drug Assistance Program, Food boxes, Housing) for clients.

• Review and submit client financial assistance requests.

• Develop and maintain cooperative working relationships with tribal and other local providers, agencies and organizations interested in RiverStone Health programs.

• Maintain databases, mailing lists, and other contact information to facilitate the ongoing communication of RiverStone Health programs.

• Company cell phone will be provided for client communication purposes.

Non-Essential Functions/Other duties as assigned                            ≥5%

• Perform other duties as assigned in support of RiverStone Health’s mission and goals.

Education and Experience:

Minimum Qualifications

• Completion of License Practical Nursing or Medical Assistant program

• Any combination of experience and training which provide the equivalent scope of knowledge, skills, and abilities necessary to perform the work.

Preferred Qualifications:

• Experience working with underserved population.

• Experience working in a customer service environment.

Required Certificates, Licenses, Registrations:

• Unrestricted LPN license or MA Certification

• Valid Montana driver's license

• On-the-job training emergency preparedness training in ICS 100, 200 and 700.

Knowledge, Skills, and Abilities:

• Computer literacy, in Microsoft Office Suite.
• Ability to maintain a calm and positive demeanor during difficult client interactions.
• Ability to display non-judgmental and empathetic listening skills.
• Knowledge and understanding of protected sensitive patient health information (HIPAA) and confidentiality.
• Ability to work collaboratively and maintain a positive work environment.
• Ability to perform job duties with integrity and innovation to ensure completion and an elevated level of quality.
• Ability to understand and adhere to required administrative policies and procedures.
• Excellent communication skills to ensure efficiencies and quality customer service.
• Ability to relate to and motivate diverse members of the community.
• Ability to develop and maintain partnerships with a diverse mix of local organizations, businesses, health providers and other applicable individuals.
• Self-starter and strong organizational and planning skills.

Customer Service Excellence:

• Doing things right the first time.

• Making people feel welcome.

• Showing respect for each customer.

• Anticipating customer needs and concerns.

• Keeping customers informed

• Helping and going the extra mile

• Responding quickly

• Protecting privacy and confidentiality

• Demonstrating proper telephone etiquette

• Taking responsibility for handling complaints

• Being professional

• Taking ownership of your attitude toward Service Excellence.

Supervision:

• None

Physical Demands and Working Conditions:

• Work is mainly performed in a clinic, home or office setting.
• Someday travel is required to attend community-based meetings and home visits.
• Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, other vehicles, etc. Travel occurs in all weather conditions, including extreme heat and cold.
• Create and maintain a safe/secure working environment by adhering to safety, security, and health requirements. Integrates injury, illness, and loss prevention into job activities by attending any necessary training and implementing best practices.

Freedom to Act & Decision Making:

• Uses independent judgement.

• Work is structured by public health regulations and established medical practices.

• Decisions directly affect the quality of services provided to the public.

Communications & Networking:

• Daily written and verbal communication with patients, clients and other RiverStone Health staff.

• Work directly with other team members to provide quality customer service for patients and customers.

Budget & Resource Management:

None