Los Angeles County HIV Mental Health Task Force

The Nurse Case Manager will provide case management services to an ongoing case load of individuals living with HIV/AIDS.  The RNCM works as part of an interdisciplinary team to formulate care plans based on assessment and provision of care priorities. Coordination of services with the social worker /mental health clinician, and other psycho-social support services for persons with HIV/AIDS needing higher level of care. The RNCM will work under the Home Based Case Management (HBCM) program or the Medical Care Coordination (MCC) program. The RNCM for HBCM will coordinate services for persons who are homebound and when applicable, will coordinate activities with in-home support, skilled nursing facilities, hospital nursing personnel, members of the interdisciplinary team and with the physician in the clinic. The RNCM for MCC will act as team lead to ensure the patient’s needs are met and their care is coordinated through the delivery of brief interventions focused on patient education, treatment adherence, managing side effects, medical nutrition therapy, co-infections, and preventative care.

1. Identifies and enrolls persons with HIV/AIDS into a case management program providing services within the HMCM and MCC programs.
2. Works as part of an interdisciplinary team to formulate care plans based on assessment and provision of care priorities.
3. Coordinates services with the social worker /mental health clinician and other psycho-social support services for persons with HIV/AIDS needing higher level of care.
4. Coordinate access to other services including, nutrition services, legal services, in-home support, attendant care, and skilled nursing.
5. Actively participants in Case Conferences to determine appropriate care plan for patients.
6. Delivers brief interventions focused on patient education, treatment adherence, managing side effects, medical nutrition therapy, co?infections, and preventative care.
7. The Nurse Case Manager will participate in the developing of all program material, policies and procedures related to the nurse case management program; includes creating program manuals and Quality Management policies.
8. Develops program informational and educational materials and various forms.
9. Cultivates and develops community social services linkages for patients and families with HIV/AIDS.
10. Identifies third party payer sources, completes Medi-Cal and/or Medi-Care paper work; Qualifies participants for the State AIDS Case Management Program services.
11. Collects demographics, compiles monthly reports and statistics.
12. Works to coordinate support services with hospital discharge planners as needed.
13. Attends staff meetings, programmatic trainings/meetings, various community meetings, task forces and local consortium.
14. May be required to perform clinical nurse duties as needed
15. Performs other related duties as assigned.

1. Graduation from an accredited Baccalaureate School of Nursing or a related field and two years experience in administration or management, public health nursing and/or case management or an RN with three years experience in home health care and/or case management.
2. Current, active, and unrestricted registered nursing license provided by the State of California.
3. A minimum of one year experience working with HIV populations preferred.
4. Bilingual: English/Spanish required