Legacy Community Health is a premium, Federally Qualified Health Center (FQHC) that provides comprehensive care to community members regardless of their ability to pay. Our goal is to treat the entire patient while improving their overall wellness and quality of life, in addition to providing free pregnancy tests, HIV/AIDS screening. At Legacy, we empower patients to lead better lives by promoting healthy behaviors and offering resources such as literacy classes, family planning services, and nutrition and weight management information.

Our roots began in 1981 as the Montrose Clinic, with specialization in HIV education, testing, and treatment. Since then, the agency has expanded to 10 clinics in Houston, one in Baytown, two in Beaumont, and one in Deer Park with extensive services that include: Adult primary care, HIV/AIDS care, pediatrics, OB/GYN and maternity, dental, vision and behavioral health. We also service students within KIPP and YES Prep schools. Legacy is committed to driving healthy change in our communities.

Job Description

The Ryan White Medical Case Manager provides a wide range of psychosocial services to HIV+ patients referred by Legacy providers, including but not limited to: case management, linkages to care, patient advocacy, assistance with medication and visit adherence, and psychological and social support. (Grant Funded).

Essential Functions

• Identify and screen HIV+ individuals whom have been referred for social service needs by Legacy providers.
• Assess each client’s medical and psychosocial history and current service needs including resources to meet the needs of daily living.
• Provide information, referrals, and assistance with linkage to medical, psychosocial, and basic needs services as needed with the goal of improving patients’ independence and overall health.
• Assist patients with improved medication adherence, visit adherence, and overall health status.
• Assess for substance use/abuse and connect to available treatment resources.
• Advocate on behalf of clients to decrease service gaps and remove barriers to services.
• Assist patients who have been lost to care with returning to medical services.
• Must comply with the standards of care including DSHS Texas HIV Management Standards and other applicable standards of care.
  • Follow program standards and protocols, including completing Comprehensive Assessments and Individualized Care Plans with patients.
  • Maintain paperwork and documentation necessary for program standards.
  • Attending trainings community meetings as needed.
• Monitor the efficacy and quality of services through periodic re-evaluation with peers and supervisor.
• Document service provided in EHRS client record within 72 hours.
• Participates in Legacy’s Performance Improvement and Quality Assurance Program.
• Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to insure a professional, responsible and courteous environment.
• Promotes effective working relations and works effectively as part of a team to facilitate the department’s ability to meet its goals and objectives.
• Attend required training and ongoing education offered by the agency.
  • Including but not limited to safety trainings and education sessions on Universal Precautions.
• Must be able to travel between locations as needed, including the ability to travel between Houston and Beaumont.
• Maintains work area and equipment in condition required by Legacy standards.
• Works within the context of a primary care medical home, applying a team based approach to care while working in partnership with patients/families to promote: timely access to care, understanding of patient care that is culturally sensitive and language appropriate, continuity of care, and the improvement of the whole-person through the teaching of appropriate self-management skills.
• Performs other duties as assigned.

Education & Training Requirements

• Bachelor’s degree in health, human, or education service; or, equivalent experience required
• All licensed professionals must maintain their professional licenses as defined by their respective Texas licensing/examining boards, required.
• Licensed Master of Social Work is preferred

Work Experience

• One year of case management experience with people living with HIV and/or persons with a history of mental illness, homelessness, or chemical dependence is required.
• Requires a working knowledge of community resources and treatment issues related to HIV.
• Must be able to manage multiple deadlines and prioritize
• Adept in decision making responsibilities

Benefits

• 9 Holiday + 1 Floating Holiday
• PTO
• 403b Retirement Plan
• Medical / Vision / Dental (if eligible)