TGNB Case Management Coordinator presso Amida Care

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member. 

We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit https://www.amidacareny.org for more information about the Amida Care culture.

We are actively seeking a highly motivated, innovative and experienced individual to join our team as the TGNB Case Management Coordinator. Compensation will be commensurate with experience.

Position Summary:

The TGNB Case Management Coordinator will play a key role in supporting Amida Care’s HIV-Negative Transgender and Non-Binary (TGNB) members by conducting and documenting case management (CM) assessments, reassessments, and HIV risk assessments. This position is responsible for delivering essential case management services, including TGNB health navigation, HIV prevention education, and referrals to community-based partners to address social determinants of health. The TGNB Case Management Coordinator will collaborate closely with external case management agencies and care teams to coordinate member support, while ensuring timely collection and accurate logging of progress notes and required documentation. By fostering strong partnerships with providers and community organizations, this role will help ensure members receive comprehensive, culturally competent, and person-centered care.

Responsibilities:

• Conduct telephonic reassessments and HIV risk assessments every 180 days for assigned caseload. 
• Refer members to the appropriate case management agency after assessment completion, if requested by member.
• Perform monthly generation and on-going review of case management site rosters and identify members who are actively receiving case management.
• Obtain comprehensive psychosocial case management assessments/progress notes for those active members assigned to a case management agency.
• Document elements of the assessment, including the needs identified and member’s input.
• Review and address Gaps in Care with members and providers as applicable. 
• Refer members deemed unreachable to the Retention in Care Unit (RICU). 
• Refer members to external agencies as requested through Unite Us and perform referral follow-up.  
• Educate members and providers regarding plan benefits, policies, and support services available to members.
• Provide direct individual interventions including elements of case management and advocacy, referral and follow-up meetings in-person or by telephone.
• Assist in strengthening transgender programming and HIV prevention programming across all Amida Care departments. 
• Participate in meetings with the Gender Identity Support Team (GIST) and the HIV Prevention Program and assist with related projects as directed. 
• Assist members with linkage to appropriate TGNB-competent and GAS-specializing providers. 
• Assist with responding to GAS Health navigation requests as needed.
• Collaborate with external case managers and care teams to ensure that identified needs are being met.
• Assist with the addressing of concerns or issues with CM agencies.
• Perform other duties as assigned.

Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.  

EDUCATION REQUIRED

• Bachelor’s degree in social work or a bachelor’s degree plus at least one (1) year of relevant work experience in a human services field.

EXPERIENCES AND/OR SKILLS REQUIRED

• One (1) year of experience working with HIV Case Managers, Care Coordinators, and/or Primary Care Providers in a social service or medical setting.
• Demonstrated knowledge of case management with focus on HIV prevention or LGBTQ care navigation. 
• Strong knowledge of Microsoft Office (Word, Excel, and PowerPoint).
• Demonstrated judgment of safety and confidentiality issues.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.