Registered Nurse - Case Manager

  • Aids Healthcare Foundation
  • Washington, DC 20001, United States
  • Jan 05, 2018
Full time Case Manager Nurse Registered Nurse

Job Description


Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

If so, AIDS Healthcare Foundation is the place for you!

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

AHF’s core values are:

• Patient-Centered
• Value Employees
• Respect for Diversity
• Nimble
• Fight for What’s Right
STILL INTERESTED? Please continue!



The Ryan White Registered Nurse Medical Case Manager (MCM) contributes to the success of the Medical Care Management Programs by managing the daily work flow to achieve high quality care management delivery and positive clinical outcomes, promote client retention in care, adherence to prescribed medical and medication therapies, while meeting the administrative and contractual performance targets, documentation standards and billing requirements of the  Medical Care Management Programs.  

In addition: The RN Medical Case Manager provides case management services to manage and maintain patients in care in order to improve health outcomes. Provide a link for clients to appropriate entitlement and support services and serves as a portal for critical client education. The MCM screen cases for possible case management services according to the contract and RW jurisdiction’s predetermined criteria, evaluates physician's treatment plan and other records to develop a care plan to assist patient to maintain adherence to medications, appointments and other medical follow up, consults with providers, clients and family members as needed, documents all initial and concurrent reviews, including, but not limited to diagnosis, symptoms, interventions, goals and plan for next review

Essential Duties & Responsibilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Includes the following.  Other duties may be assigned.

Maintains extensive knowledge regarding the current standards of HIV/AIDS care and case management processes.

Attends all required educational events, e.g., HIPAA, Fraud/Waste/Abuse, Cultural and Linguistic Sensitivity, DOH-HASTA trainings, and HIV updates.

Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management.

Maintains current knowledge of the District HIV Medical Case Management Guidelines, 2014 second edition or newer.

Interviews patients and families to assess needs and risk categories to develop and implement appropriate plans of care and assessments

Establishes long and short term goals for the patient/family which are S-M-A-R-T 
(Smart, Measurable, Achievable, Realistic, Timely)

Creates an individualized plan of action in collaboration with the patient, family, medical caregivers and community agencies.  Implements, monitors and evaluates the plan of care and its effectiveness.  Revises as necessary.

Monitors hospital, emergency room, outpatient and ancillary services; lab values and patient satisfaction to determine program effectiveness.

Educates patients regarding the disease process and medications, methods for improving medication compliance, available community resources and other pertinent information.

Reviews medical records to identify needs and tracks outcomes.  Updates plans of care (ISP) as required and as needed.

Performs reassessments as required by contractual/DOH HIV MCM Guideline requirements

Utilizes the 104 day report to conduct outreach by phone and/or home visits to recapture and retain patients in care.  
Assures all Department of Health (DOH) -HASTA jurisdiction MCM acuity driven client contacts targets are met and documented per HIV MCM Guidelines. 

Assures all clients enrolled in the HIV MCM program meet RW DOH-HASTA eligibility criteria when services are delivered.

Continually strives to meet the goals of the HIV MCM program when working with clients:
•    Taking all medications as prescribed
•    Making and keeping of medical and case management appointments
•    Addressing barriers to care and treatment
•    Adapting to therapeutic lifestyle changes as necessary  

Collaborates with ASO’s and other community services in the Eligible Metropolitan Area (EMA), including specialty care providers, as necessary to ensure appropriate access to services and follow-up on the results to such referrals.

Conducts home visits, when necessary to identify barriers and/or facilitate care management.

Documents effectively in the computer system and tracks outcomes of care on an individual and aggregate basis regarding the patient and provider population.

Updates CareWare information as appropriate.

Updates the GAIN SS surveys per DOH and HASTA requirements

Enters all documentation of activities in the computer system within 48 hours of performance of said activities.

Conduct training for other associates regarding the overall Case Management Program and specific processes such as the case management referral process.

Maintains detailed record of time spent providing service to each patient and submits this information at regular intervals for timely billing.

Monitors patient’s acuity level in an ongoing fashion to ensure disenrollment when patient is no longer an acuity level that  necessitates case management, In DC monitor the Acuity Tool and establishes Clients needs from the Acuity Score, and follows patient accordingly. 

Provides feedback to the referring provider regarding planned disenrollment from program.

Participates in local EMA functions in the community and scheduled HASTA meetings.

Participates and/or leads quality improvement activities as assigned.

Assists in tracking, resolving and reporting of complaints/grievances.

Maintains information in a confidential manner at all times.

Supervises and monitors the duties and responsibilities assigned to the Medical Care Coordinator.

Directs and monitors peer navigators activates to assist in returning members who have been lost to care

Participation in AHF Meetings/Committees
Monthly staff meeting
Interdisciplinary Team meetings
Quality Improvement meetings
Grant Overview meetings
Attends other meetings as required within AHF
Attends County Meetings as they pertain to MCM in DC
Attends Planning Council meetings

Supervisory Responsibilities
The RN MCM supervises the Medical Care Coordinator. As the RN Medical Case Manager, the RN MCM will oversee and monitor the assessments of the Medical Care Coordinator. The RN MCM will collaborate with the Medical Care Coordinator to ensure all reassessments have been conducted, all follow up phone calls are done on a timely manner and review all new patients with the Medical Care Coordinator as this is important for continuity of care and patient follow up.  

Job Requirements:


To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

•    RN licensure and three (3) years clinical practice experience and practice case management within the scope of their licensure (based on the standards of the discipline).
•    A Bachelors Degree in Nursing (preferred).
•    Certification as a Case Manager within 12 months of employment 
•    ACRN within 18 months of employment 

Graduate of an accredited professional Nursing program, BSN Degree preferred.
Certificates, Licenses and/or Registrations
Valid Washington DC Registered Nurse license 
Certified in Case Management (CCM) within 12 months of employment
AIDS Certified Registered Nurse within 18 months of employment
Current CPR Certification
Current driver’s license with proof of liability insurance.

•    3 or more years’ clinical experience in a health care environment.
•    A minimum of one year experience working within HIV case management or relevant adult community health, clinical or hospital based environment. 
Other Skills & Abilities/Qualifications: 
•    Demonstrated ability for assessment, evaluation and interpretation of medical information. 
•    Skilled in the operation of the computer including proficiency in Microsoft Office Word, Excel and Access. 
•    Should have a high level of understanding of community resources, treatment options, home health availability, funding options and special programs.
•    Preferred knowledge of HIV/AIDS and related issues as they relate to a diverse population.
•    Bi-lingual preferred.
•    Must be able to travel up to 25% of the time within the community to make personal visit to patient’s home, hospitals and/or healthcare centers.

Computer/Software Skills & Abilities
To perform this job successfully, an individual should have knowledge of Word Processing software.

Language Skills
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Mathematical Skills
Intermediate Skills:  Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry.

Reasoning Ability
Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.