UNM Medical Group

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Medical Case Manager - Chronic Care

at UNM Medical Group

Posted: 6/25/2020
Job Reference #: 1759
Keywords: insurance

Job Description

UNMMG Truman Health Services

Pay Range:
Commensurate with experience

Job Code:

# of Openings:

Position Class Code/Title: S1005 / Medical Case Manager – Chronic Care
FLSA: Exempt
Grade: CE09


UNM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center.  UNM Medical Group, Inc. is a New Mexico non-profit corporation and is an equal opportunity employer.  UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, paid leave and 403b retirement for benefits eligible employees.

Truman Health Services is a NCQA Patient Centered Medical Home which provides the highest level of care and latest treatment options for New Mexicans living with HIV, requiring gender services or seeking PrEP. We offer a variety of treatment services utilizing a holistic approach towards supporting our patients’ medical, social and mental health needs. Truman Health Services is seeking an experienced candidate to join our Case Management Team.

We are thrilled to announce our recruitment for a Medical Case Manager to join our highly experienced case management team. We are seeking an experienced individual to provide intense medical case management services to outransgender/gender non-conforming clients who receive primary care at our clinic. Core services provided by candidate may include coordination of case with a multidisciplinary team to ensure treatment compliance and evaluating/anticipating ancillary, wrap-around and support services. The chosen candidate must be focused, able to handle multiple activities at once, have excellent written and oral communication skills, exceptional computer skills and be very detail oriented.

Priority will be provided to candidates who are:

Experienced providing medical case management services to medically and socially complex populations.

Experienced providing social support services to people living with HIV/AIDS.

Experienced working with the LGBTQ community.

Experienced working in a community based multi-disciplinary setting.

Bilingual English/Spanish.

The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified.


Under indirect supervision, provides a full range of medical and supportive case management services to patients and their families in order to improve quality of life and maintain the highest possible ability to function within the community. Functions as a member of and facilitator for the patient’s care team to ensure comprehensive coordination of medical and psychosocial services.


  1. Serves as liaison, manager and/or advocate for services, placements, referrals and ensures coordination of care, treatment and support within UNMHSC as well as community agencies, such as hospitals, nursing homes, hospices and rehabilitation facilities.
  2. Assists clients in developing goals and areas of need, and when required, assists in developing treatment plans which are assessed regularly; conducts medication and mental status assessment and determines required level and frequency of services.
  3. Assesses patients, evaluates effectiveness of care plan and progress made by client, participates in patient treatment planning, and case review with patient care providers, when applicable.
  4. Coordinates and monitors services, including comprehensive tracking of client activities in relation to care plan.
  5. Identifies and provides emergency crisis services as necessary and responds according to accepted crisis intervention methods and techniques; coordinates other services as appropriate.
  6. Conducts home, hospital, nursing home and other facility visits to ensure appropriate care coordination and positive patient outcomes.
  7. Ensures timely and accurate enrollment and recertification of all Ryan White programs in order to qualify and maintain eligibility for NM Department of Health, UNM Truman Health Services medical care and treatment and UNMTHS pharmacy services.
  8. Identifies eligibility and support options for accessing care, treatment and community resources and programs; assists patients with the completion of applications for programs such as disability, SNAP, unemployment, insurance, emergency financial assistance.
  9. Facilitates client access to community resources, including locating housing, food, clothing, legal services, school programs, vocational opportunities or services, providers to teach life skills, and relevant mental health services; assists client to develop natural resources and make contact with social support networks.
  10. Acts as the patient’s retention specialist providing appointment scheduling, reminder calls, eliminating barriers to avoid missing appointments, including coordination of transportation, and following up regarding missed appointments.
  11. Provides information, education, referrals and emotional support to patients in a compassionate, culturally sensitive and professional manner.
  12. Documents all client encounters and contacts made on behalf of clients; completes and submits billing documentation as appropriate; maintains comprehensive client files, which may include documents held for safekeeping on behalf of the client.
  13. Maintain current knowledge related to HIV and LGBTQ health and psychosocial issues and treatment options available.
  14. Maintains and reports applicable statistics regarding programs and client services.
  15. Participates in team and staff meetings, trainings and developmental activities as requested.
  16. Maintains highest level of patient confidentiality.
  17. Performs miscellaneous job-related duties as assigned.


High school diploma or GED and 6 years of directly related experience. Completed degree from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis. Verification of education and licensure will be required if selected for hire.


  • Ability to assist patients with heath and psychosocial issues.
  • Strong interpersonal skills and the ability and desire to work effectively with a wide range of constituencies in a diverse community.
  • Advanced verbal and written communications skills including the ability to appropriately document patient’s information in an electronic medical record system.
  • Ability to gather data, compile information, and prepare reports.
  • Excellent organizational skills with the ability to prioritize duties.
  • Ability to monitor, assess and record client progress against care plan, and make adjustments to plans and services.
  • Ability to assess mental status in clients and to develop individual treatment goals and plans.
  • Knowledge of community health care and vocational services and resources.
  • Ability to plan, implement, and evaluate individual patient care programs.
  • Ability to communicate medical information to health care professionals and the public over the telephone under crisis circumstances.


  • Experience providing medical case management services to medically and socially complex populations.
  • Experience providing social support services to people living with HIV/AIDS.
  • Experience working with the LGBTQ community.
  • Experience working in a community based multi-disciplinary setting.
  • Bilingual English/Spanish.


  • Must be employment eligible as verified by the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) and the Government Services Administration (GSA).
  • Must pass a pre-employment criminal background check.
  • Fingerprinting, and subsequent clearance, is required.
  • Must provide proof of varicella & MMR immunity or obtain vaccinations within 90 days of employment.
  • Must obtain annual influenza vaccination.
  • If this position is assigned to a clinical area, successful candidate will be required to complete a pre-placement medical evaluation/health screen.  Required N-95 mask fitting, testing, vaccinations to include annual TST, Tdap, and Hepatitis B will be determined based on location and nature of position


  • Work is performed in an interior medical/clinical environment.
  • Home, hospital & nursing home visits.
  • No or very limited exposure to physical risk.
  • No or very limited physical effort required.

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