Medical Case Manager

Park West Health System,Inc.; Baltimore (MD); On-site; USD 65,000 - 90,000; Full time

Job summary

Park West Health System,Inc. seeks a Medical Case Manager to provide case management and adherence support for the Hidden Garden Program in Baltimore, MD. This role coordinates eligibility, referrals, care plans, and patient documentation to meet state and federal standards.

Required: Master’s in Social Work and Maryland licensure (LMSW or LCSW-C) with at least two years’ social service experience. Strong communication, advocacy, and cultural competence are essential.

Qualifications

• Master’s Degree in Social Work required.
• Maryland licensure LMSW or LCSW-C required.
• Two years of social service experience.
• Experience with HIV/AIDS and minority communities preferred.
• Strong advocacy, coordination, and documentation skills.

Responsibilities

• Confirm Ryan White eligibility and required documentation.
• Receive referrals and ensure eligibility compliance (HIV status, residency, income, insurance, signatures).
• Refer clients to primary medical care for follow-up, labs, and prescriptions.
• Monitor assessments and care plans; secure staff and client signatures for updates.
• Determine level of case management support and visit frequency.
• Make internal and external referrals and resolve with Case Assistant.
• Monitor insurance application progress.
• Maintain various contact methods and document progress toward goals.
• Provide treatment adherence support, advocacy, and crisis intervention.
• Provide monthly narratives identifying barriers and solutions.
• Liaise with Consumer Advisory Board (CAB).
• Facilitate monthly health education or support groups.

Skills

Leadership

Communication

Cultural competence

Advocacy

Care coordination

Problem solving

Education

Master’s Degree in Social Work

Job description

Position Summary

The Medical Case Manager provides medical case management/treatment adherence services for The Hidden Garden Program.

Essential Functions

• Confirm Ryan White eligibility and applicable documentation
• Receive referrals from outreach staff and ensure compliance with eligibility requirements for all clients, including HIV status, residency, income, insurance documentation, and client signatures on agency forms.
• Refer client to primary medical care for follow up visits, labs, and prescription.
• Monitor initial assessments, care plans and overall encounters to ensure identified client needs, goals, and interventions are developed and updated with staff and client signatures to ensure compliance with state and federal outcome indicators and standards of care.
• Determine the level of case management assistance required and frequency of visits.
• Make appropriate internal and external referrals to core medical and other health and support services and work with Case Assistant until they have been resolved.
• Monitor completion of insurance applications.
• Maintain face to face, telephone, home visits and other encounters with and on behalf of the client and document progress toward achievement of care plan goals.
• Provide treatment adherence support, advocacy, consultation, and crisis intervention to the client and other family members.
• Provide monthly narratives identifying barriers with solutions to system and operations challenges.
• Provide liaison support to Consumer Advisory Board (CAB).
• Facilitate monthly health education or support group.

Core Responsibilities and Organizational Expectations

• Provides courteous, responsive, and service-oriented support to patients, visitors, and colleagues. Promotes a respectful and welcoming environment, communicates clearly, and works collaboratively to support team and organizational goals.
• Performs all duties in a manner consistent with Park West Health System's mission, vision, and organizational values, demonstrating a commitment to quality care, respect, and service excellence.
• Adheres to all applicable federal, state, and local regulations, as well as organizational policies and procedures, including HIPAA, privacy, and security standards.
• Follows all infection control, workplace safety, and risk management protocols. Participates in quality improvement and performance initiatives as appropriate to the role.
• Maintains professionalism, reliability, and accountability in attendance, performance, and communication. Completes required trainings and maintains job-related competencies.
• Participates in staff meetings, trainings, and organizational initiatives. Supports operational needs and performs other related duties as assigned to ensure efficient and effective operations.
• Performs other duties on an as-needed basis.

Qualifications

Education

• Master’s Degree in Social Work from an accredited graduate program.

Licensure

• Current Maryland licensure required: LMSW or LCSW-C.

Training and Experience

• Two years’ experience working in a social service environment
• Relevant background experience and sensitivity to HIV/AIDS related issues and African-American and other minority community issues.
• An awareness of local AIDS services and resource providers at the public and community levels.

Skills

• Demonstrated leadership and team building skills
• Strong communication skills across internal and external stakeholders
• Cultural competence with special emphasis on HIV, LGTBQI+ and marginalizes populations
• Ability to coordinate within complex care systems and community resources
• Advocacy and client-centered care approach
• Adaptability and problem solving