Open Accessibility Menu

Medical Case Manager


The Medical Case Manager (MCM) will provide continuous comprehensive care coordination services which include initial assessment, reassessment, completion of service plan; treatment plan implementation, monitoring, advocacy, and referral service/follow up. The Medical Case Manager will facilitate linkage to care activities to access and retain people who are HIV positive into medical care services. The Medical Case Manager will perform care coordination for those HIV positive patients who are enrolled in Morris Heights’ CARE Program.
Must be able a critical thinker strong detail to analysis; must be detail-oriented, organized, self-motivated, able to work independently and in groups, meet project deadlines, and possess strong problem-solving skills.

Essential Duties & Functions:
Care coordination activities include but are not limited to:
  • Coordination of medical & psycho social services, ensuring compliance with medical appointments and follow up;
  • Treatment education, medication adherence support, referral and linkages to appropriate services.
  • Completion of semi-annual individualized integrated care plan.
  • Referrals to services to help patient obtain needed services.
  • Phone and home visit monitoring referral to the Outreach Navigator to follow up with patients lost to care.
  • Documentation in medical record of all contact made with patients to link, engage and retain him/her in care.

The Medical Case Manager will conduct adherence support, risk and harm reduction counseling, partner notification services, provide information on advanced directives and issues relating to death and final disposition, referrals to agencies that provide insurance and child and guardianship arrangements.

  • Develop and maintain a referral network of community-based organizations that provide a wide variety of services for HIV infected/affected clients.
  • Refer all newly diagnosed and known positive patients to prevention counseling.
  • Coordinate with Data Management Staff to review and oversee quality assurance of new and existing patients.
  • Communicate with Program Coordinator and Data staff and work closely with primary care providers, and other staff, to ensure patients’ access, linkage, and retention in care.
  • Participate in Quality Improvement, case conference and trainings.
  • Participate in HIVQUAL/QM activities.
  • Other appropriate duties as assigned to support CARE services and patient care needs.

Maintain required documentation of all services provided in the client’s permanent record, in accordance with MHHC policy and procedure.

  1. Education & Experience: Associate Degree or bachelor’s degree in related field required; Certification of attendance at New York State sponsored Motivational Interviewing training preferred. Must be knowledgeable on HIV services delivery model. Bilingual (Spanish) desirable.

  2. Interpersonal Skills: Ability to foster good working relationships with clinical and administrative staff. Clearly communicate with individuals and groups of end users, effectively prioritize and communicate concerns to management, and communicate with outside vendor community. Interact effectively in a team environment. Ability to speak effectively in group or individual settings. Bilingual (Spanish) desirable. Ability to write and complete routine reports and correspondence Ability to read and interpret documents such as procedure manuals.

  3. Reasoning Ability: Ability to analyze problems, solve problems with practical solutions, analyze impact of EHR changes on workflow, prioritize users’ requests, understand EHR data structure, and logically program EHR templates and reports. Must be able to handle confidential information in accordance to internal policies and procedures and external regulations.

  4. Language Skills: Strong oral and written communication skills a MUST. Able to clearly explain technical concepts to non-technical individuals. Translate clinical users’ template and report requests into computer programming specifications. Document in procedure manuals. Type/use keyboard accurately and with reasonable speed.

  5. Mathematical Skills: Ability to add, subtract, multiple, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentage. Ability to draw and interpret various graphs.

  6. 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.
    Ability to stand, walk, sit, talk, and hear for variable lengths of time during the work day. Ability to view computer screen for extended periods.

  7. Certifications/Licenses: Certificate of attendance from New York State AIDS Institute on other topics related to job title.


$23.92 per hour