Medical Management Manager jobs in Massachusetts

SUMMARY: 

The Medical Case Manager  is responsible for overseeing a team of Medical Case Managers, ensuring efficient day-to-day operations, and providing comprehensive case management, including social services and medical coordination, for clients infected with HIV. The role focuses on guaranteeing access to the highest quality care and delivering services in a culturally competent manner.

ESSENTIAL DUTIES AND RESPONSIBILITIES: Other duties may be assigned.

Supervisory Responsibilities:

• Lead and supervise a team of Medical Case Managers, providing guidance, support, and regular performance feedback.
• Coordinate and oversee day-to-day operations, ensuring team efficiency and adherence to protocols.
• Foster a collaborative and positive team environment.

Communication and Collaboration:

• Maintain regular communication with other departments, organizational resources, and supervisors to ensure effective collaboration and coordination of services.
• Foster strong relationships with external partners, healthcare providers, and community organizations to enhance the support network for clients.
• Organize and participate in community meetings to improve awareness of available services and resources.
• Facilitate internal meetings to enhance team awareness, share updates, and encourage a culture of continuous improvement.

Case Management Responsibilities:

• Maintain a case load of not less than 30 HIV consumers.
• Demonstrate regular communication with the assigned case load.
• Conduct initial assessments as mandated by payer sources.
• Complete re-assessments as mandated by payer sources.
• Develop, implement and monitor individual service plans in a measurable manner.
• Ensure accurate and timely documentation, including client medical records, utilization forms, and HDAP forms.
• Assist in health benefits procurement and maintenance of medical insurance.

Referral and Support Responsibilities:

• Facilitate supported referrals for medical care, housing, food resources, and other concrete social services.
• Accompany clients to medical appointments or be present when necessary.
• Facilitate supported referrals for behavioral health services.
• Assist clients with developing and maintaining a budget.
• Co-Facilitate peer support groups and activities as required.

Administrative and Team Participation:

• Participate in administrative and clinical supervision as required.
• Attending weekly interdisciplinary treatment team meetings.

Flexibility and Additional Responsibilities:

• Occasionally work on weekends/evenings as assigned.
• Additional Responsibility.

QUALIFICATIONS AND REQUIREMENTS:

• High school diploma with relevant experience or Bachelor's degree in a relevant field (e.g., Social Work, Healthcare Administration).
• Previous experience in medical case management, with a demonstrated ability to lead and supervise a team.
• Strong knowledge of healthcare regulations, compliance standards, and case management principles.
• Excellent communication and interpersonal skills.
• Analytical and problem-solving abilities.
• Proficient in using relevant software and databases for case management. 

LANGUAGE SKILLS:

• Bilingual/bicultural preferred: Spanish, Khmer, Portuguese.
• Ability to read, speak, and write in English.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk and hear.  The employee frequently is required to stand; walk; sit; use hands to finger, handle, or feel; and stoop, kneel, crouch, or crawl. 

 WORK ENVIRONMENT: 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 The noise level in the work environment is usually moderate.