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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 people 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 Care Coordinator - TGNB Health. Compensation will be commensurate with experience.

Position Summary:

This position requires experience in Transgender/Non-Binary (TGNB) clinical care and gender affirming surgery (GAS) and plays a key role in the coordination of Amida Care’s TGNB clinical services, and care coordination for TGNB members, as well as serves as a resource for the community, Amida Care staff, community partners, and providers.

Responsibilities

• Clinical leader for TGNB Care Coordination and TGNB Health.
• Participate in regularly scheduled ICT Meetings. Ensure Amida Care’s Integrated Care Model is operationalized with team structure and the members’ complex multidisciplinary service needs are met.
• Perform clinical oversight of case review, employing critical thinking skills and presenting cases to medical directors and other clinicians.
• Communicate with members to ensure they are receiving services and case in accordance with established clinical guidelines and the Plan’s benefit package; review clinical documentation, including laboratory values, to ensure members are receiving appropriate care and implement strategies to address unmet needs as appropriate. Ensure completion of documented care coordination with the Amida Care Authorizes operation systems.
• Perform daily review of inpatient census to ensure members are receiving care and services in accordance with established clinical guidelines in the most appropriate care setting. Follow up with members and providers when a need is identified that will support improved health outcomes for behavioral and physical health.
• Provide direct services to members, including psychosocial reassessments, risk reduction activities, community outreach, and events targeting individuals of transgender experience living with HIV/AIDS as needed.
• Provide direct individual interventions including elements of case management and advocacy, referral and follow-up meetings in-person or by telephone.
• Engage members and providers when a need is identified that will support improved health outcomes for the behavioral and physical health of members of transgender experience.
• Provide education on gender affirming procedures, hormone treatment and risk reduction strategies.
• Participate in review of clinical documentation, claims/utilization data to ensure members are receiving appropriate care and implement strategies to address unmet needs as appropriate.
• Conduct needs assessments to determine appropriate referrals and support.
• As needed, conduct focus groups with members of transgender experience to increase quality of care and services delivered at Amida Care.
• Provide support to the member services call center as it is related to GIST needs.
• Attend continuing education seminars, staff in-services and stay current with relevant literature to maintain familiarity with trends in transgender services.
• Ensure member confidentiality and adheres to Confidentiality and Health Insurance Portability and Accountability Act (HIPPA) policies and regulations.

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

• Minimum Licensed Practical Nurse license required.

EXPERIENCES AND/OR SKILLS REQUIRED

• One (1) year experience working with the transgender community, preferred.
• Knowledge of transgender surgical procedures, preferred.
• One (1) year experience with HIV/AIDS, medical, or chronic care preferred.
• Ability to communicate in Spanish for basic medical interactions, preferred.
• Strong knowledge of Microsoft Office (Access, Word and Excel).
• 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.