RYAN WHITE MEDICAL CASE MANAGER

The Centers; Cleveland (OH); On-site; USD 52,000 - 68,000; Full time

Job summary

The Centers in Cleveland is seeking a Ryan White Medical Case Manager to provide direct services for clients enrolled in the HIV Ryan White Program. You will perform comprehensive assessments, develop care plans, and coordinate access to medical, behavioral health, housing, and social services within a collaborative, multidisciplinary team.

Responsibilities include advocating for clients, leading quality improvement initiatives, and maintaining HIPAA-compliant records.

Qualifications

• Bachelor's or higher in Social Work with LSW licensure.
• Two+ years of related work experience in case management.
• Valid driver's license and liability insurance.

Responsibilities

• Conduct comprehensive assessments of client needs, strengths, and barriers to care.
• Develop, implement, and monitor individualized care plans with clients and providers.
• Facilitate linkage to medical, behavioral health, harm reduction, and social services.
• Provide education and counseling on HIV, HCV, substance use, and integrated care.
• Advocate to ensure access to treatment, housing, and essential services.
• Develop partnerships with local LGBTQ agencies.
• Coordinate and track referrals for timely access and follow-up.
• Collaborate with interdisciplinary teams to support holistic care.
• Lead program quality improvement projects and participate in committees.
• Support flexible scheduling evenings and one Saturday per month.

Skills

Trauma-Informed Care

Health Navigation

Advocacy

Documentation

Crisis Intervention

Time Management

Communication

Education

Bachelor's degree in Social Work + LSW

Master's degree in Social Work + LSW

Tools

EHR Systems

Job description

RYAN WHITE MEDICAL CASE MANAGER

Provides direct service to clients enrolled in the HIV Ryan White Program.

Essential Job Duties & Responsibilities

• Conduct comprehensive assessments of client needs, strengths, and barriers to care.
• Develop, implement, and monitor individualized care plans in collaboration with clients and healthcare providers.
• Facilitate linkage to and retention in medical care, behavioral health services, harm reduction programs, and social services.
• Provide education and counseling on HIV, HCV, substance use, and integrated care strategies.
• Advocate for clients to ensure access to medical treatment, medication assistance, housing, and other essential services.
• Develop relationships/partnerships with local LGBTQ agencies
• Coordinate and track referrals to ensure timely access to services and follow-up care.
• Collaborate with interdisciplinary teams, including medical providers, peer specialists, and social service agencies, to support holistic client care.
• Lead the program's quality improvement projects and participate in statewide and regional quality improvement committees.
• To support occasional evenings (ending at 8 p.m.) and one Saturday each month, flexible scheduling is available to help balance work hours.

Other Job Duties & Responsibilities

• Other related duties as assigned

Core Competencies

• Clinical Knowledge-Understanding of HIV/AIDS care and treatment including developing knowledge of the mental illness, substance use disorders, various therapeutic modalities, and related community resource.

• Trauma-Informed- Nonjudgmental approach that prioritizes client autonomy and individual needs. Ability to develop, implement, and monitor individualized care or treatment plans.
• Health Navigation and Care Coordination- Proficient in linking clients to medical, mental health, substance use, housing, and support services. Skilled n working with healthcare providers, case conferences, and multidisciplinary teams.
• Advocacy and Empowerment- Advocates for client rights, access to care and resources. Supports clients in navigating healthcare systems, insurance, benefits and legal protections.
• Documentation and Compliance- Maintains accurate, timely records and adheres to HIPAA and agency documentation standards. Familiar with data systems such as electronic health records.
• Crisis Intervention- Responds to client crises (housing loss, medical emergencies, etc.) with urgency and appropriate interventions.
• Problem-Solving- Uses sound judgment and de-scalation techniques when needed.
• Communication and Relationship Building- Builds trust with clients through empathy, consistency, and respectful communication. Coordinates with external partners and community organizations effectively.
• Time Management and Caseload Prioritization- Manages multiple cases efficiently while ensuring quality, ethical care. Prioritizes clients with the most urgent needs while maintaining regular contact with others.

Job Qualifications

• Professional II Medical Case Manager - Bachelor's degree in Social Work and Licensed Social Worker (LSW)
• Professional III Medical Case Manager - Master's degree in Social Work and Licensed Social Worker (LSW)
• Clinical license is in good standing with the state of Ohio
• Must have valid driver's license and insurance coverage with limits of $100,000/$300,000
• Two or more years of related work experience
• Willingness to work with HIV+ population

Physical Demands/Work Environment

• This job operates in a professional office environment. This role routinely uses standard office equipment. While performing the duties of this job, the employee is regularly required to speak and hear. The employee is frequently required to sit for extended periods of time, stand, walk, use hands and fingers, and reach with hands and arms. It requires the ability to lift files, open filing cabinets and bend or stand on a stool as necessary. Travel and work outside of normal hours may be required for meetings, presentations, trainings and other events.

About The Centers

• The Centers provide health, family, and workforce services at 11 locations throughout Greater Cleveland, creating life-changing solutions for people to lead healthier and more successful lives. We strive to be a service-oriented workplace that pioneers and co-creates solutions while fostering belonging in community where our team members thrive.

Supervisory

• This position does not supervise any position.