Case Manager – Immune Support Program

Job Title: Immune Support Program Case Manager

Job Summary: The Case Manager is responsible for assisting people with HIV/AIDS access for the continuum of HIV care services. In addition, the Case Manager will be responsible for providing direct services, and coordinating services for clients who are HIV+ and conducting a comprehensive uniform assessment in the following areas: health status, medical care and provider, activities of daily living and mental health status. Furthermore, the Case Manager will be responsible for maintaining comprehensive files for each client and developing a care plan based on client needs. Will represent Omni in the community, interacting and networking with community service agencies that provide services to HIV positive individuals and their families. Cultivates and maintains communication and networking with multi-ethnic organizations in the HIV/AIDS community. This position reports to the Immune Support Program Manager.

Job Duties:

  1. Functions as part of a team in the provision of patient care and performance of daily activities.
  2. Develop excellence in case management services, which will enrich and enhance the quality of life, dignity and respect of people infected and/or affected by HIV/AIDS.
  3. Conduct a comprehensive assessment and administer an acuity scale to determine the medical, psychosocial, and social service needs of HIV+ clients. Face to face and phone contact with clients completed at minimum of once every 30 days.
  4. Ensure clients are enrolled in medical care and receive appropriate referrals to needed services as established in case plan. Services include, but are not limited to: medication assistance, housing, mental health counseling, substance abuse counseling, legal services, etc.
  5. Advocate for clients and assist them in the procurement of benefits and services. Provide necessary information, referrals for established care plans and advocate for client needs.
  6. Responsible for entering all required client related data into Next Gen within two business days of completing the service.
  7. Timely professional maintenance of records and documentation, including progress notes, treatment plans and ongoing evaluation of client progress, consistent with agency expectations and ethical standards.
  8. Assists the Immune Support Program Manager in monitoring the quality assurance and evaluation process ensuring contract compliance and outcome and process objectives for clients and their families are met.
  9. Assists in the preparation of monthly narrative and statistical reports covering progress toward meeting outcome and process objectives established in the case management contract.
  10. Follow all confidentiality and HIPPA guidelines and protocols.
  11. Performs other duties as assigned or required.
  12. Provide AIDS Drug Assistance Program (ADAP) and Ryan White enrollment to own caseload and ensure all eligible clients complete the ADAP enrollment process.
  13. Increase relationships and communication with other Omni Family Health programs and locations. Represent Omni Family Health to other organizations and community groups. Network with other AIDS service providers.
  14. Provide Spanish language interpretation as required to assist clients in meeting case plan.
  15. Support and participate in activities and group events organized by Omni Outreach Department.
  16. Participate in all multi-disciplinary team meetings, staff meetings, and selective staff development trainings, as directed.
  17. Maintain a flexible schedule to allow for some weekend work as well as emergency coverage of shifts to meet the needs/demands of clients and related activities and events.
  18. Coordinate and post weekly schedules, advising Program Manager with any changes or time-off requests.


Additional Duties:


  1. HIPAA compliance - Responsible for maintaining abreast of and in compliance with all HIPAA regulations and requirements. Treats all member information confidential.
  2. Compliance - Ensure compliance with all local, state and federal regulations.
  3. QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
  4. IT - Required to learn and to use the Electronic Health Record and Practice Electronic System and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
  5. All employees will participate in Patient Centered Health Home Model at Omni Family Health.

Performance Requirements:

  1. Knowledge of organizational policies, regulations and procedures to administer patient care
  2. Knowledge of common safety hazards and precautions to establish a safe work environment
  3. Ability to identify problems, provide information and provide alternative solutions
  4. Skilled in preparing and maintaining records, writing reports and responding to correspondence
  5. Skilled in establishing and maintaining effective working relationships with patients, medical staff and the public
  6. Ability to work independently with minimum on/off site supervision
  7. Ability to maintain quality control standards
  8. Ability to react calmly and effectively in emergency situations
  9. Ability to interpret, adapt and apply appropriate written guidelines and work practices
  10. Ability to communicate clearly

Qualifications, Experience, and Education:

  • Education Required (Minimum level of education): Bachelor’s Degree in human services or related field or high school degree with 2 years experience working in non-profit social service or public health agency.
  • Certifications/Licenses Required: Current valid California driver’s license and access to insured vehicle required.
  • Experience with and sensitivity to LGBT-related cultural concerns. Knowledge of health and psychosocial issues concomitant to HIV disease. Previous HIV field experiences a plus.
  • Technical Knowledge and Skills Required to Perform the Job: Exercise tact, objectivity, sensitivity, strategy and judgment in dealing with a variety of people with a variety of co-occurring disorders.
  • Equipment: Computer literacy required, proficiency in MS Office (Word, Excel, Outlook and PowerPoint), projectors, various software including ARIES, and Microsoft office.
  • Working Conditions and Physical Requirements: Physical Activities standing, walking, sitting and lifting 25 lb. Working Traits: travel to other facilities. May work evenings and/or weekends.
  • Preference will be given to individuals with the ability to communicate in Spanish and English; written and verbal.
  • Knowledge and understanding of customs, beliefs, and needs of consumer group(s) served
  • Valid California driver's license, proof of insurance, and personal transportation

Reports to: Immune Support Project Manager. Department: Operations