Medical Case Management Supervisor

PHMC
Philadelphia, PA
Category Healthcare
Job Description
The Medical Case Management Supervisor oversees the staffing and performance of Medical Case Managers and HIV/PrEP Patient Navigators across the PHMC Health Network. The person shall possess a strong knowledge of the Philadelphia Division of HIV Health (DHH) Medical Case Management and PrEP standards and serve as a liaison to DHH around MCM activities.

Requirements

  • Provide leadership, oversight, and weekly supervision to the HIV Medical Case Managers and PrEP Patient Navigators.
  • Serve as a spokesperson for the Medical Case Management program to DHH and be able to speak to MCM activities and workflows confidently and accurately.
  • Ensure compliance with all DHH and HRSA standards related to HIV Medical Case Management, HIV testing, and PrEP care coordination.
  • Conduct bi-weekly patient chart reviews and CAREWare audits to ensure documentation accuracy.
  • Ensure all DHH training requirements for MCM Supervisors are met.
  • Maintain a strong, up-to-date knowledge of community resources and public benefits.
  • Serve as a liaison between pharmaceutical benefits programs, insurance plans, the PHMC Health Network, and/or the patients regarding medical benefits, medical bills, billing questions, sliding fee schedule questions, and/or payment arrangements related to their medical care.
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