Summary
The Case Manager, Nutrition Services Navigator is responsible for managing all aspects of agency nutrition services for people living with HIV/AIDS to promote achievement of optimal viral suppression. Navigator oversees implementation of established CARE plan goals through delivery of nutrition services to clients via the food pantry, home-delivered meal programs, and nutritional supplements.
Specific Responsibilities:
Case Management, Nutrition Services:
- Implements with the client a comprehensive nutrition care plan, within the overall client IAS care plan, to include a detailed nutrition access plan to maintain and/or regularly access healthy food and nutrition services through direct linkage, advocacy, education, and support.
- Works collaboratively with community support to additionally increase access to;
- HIV/AIDS Medical Services, Education and Resources: primary and specialized medical care, dental care, Ryan White services, health insurance, indigent healthcare resources, hospice/home health, treatment education / adherence counseling and substance abuse/mental health therapy.
- Community Social Services and Resources: Entitlements, Public Assistance, housing, financial assistance, employment, education and legal (civil and criminal).
- Maintains and increases community relationships with food service providers, food banks and social service agencies specializing in nutrition and hunger services.
- Participates in community hunger and food services initiatives such as, but not limited to, Community Foundation of Middle Tennessee Food and Hunger series and Second Harvest community meetings
- Secures and maintains needed program(s) eligibility documentation.
- Maintains needed documentation of services rendered to include: contacts, units, progress notes, acuity scales, assessments and outcomes.
- Maintains work consistent with Department/Team Quality Assurance Standards and nationally recognized standards associated with providing comprehensive case management services to PLWHA vulnerable for food insecurity.
PROGRAM NAVIGATION and DELIVERY
- Establishes, implements, and maintains policy and procedure consistent with professional level of care for Case Management, Nutrition Services in conjunction with appropriate CQI standards and measures for services rendered.
- Works with Community Engagement manager to ensure proper and adequate recruitment, placement and evaluation of nutrition services volunteers including training and supervising.
- Develops and manages routes and schedules for home/community delivery of nutrition resources.
- Manages inventory and restocking of food pantry including order /purchase of food and coordination of volunteers for restocking and food bag preparation.
- Completes agency documentation for individual and program services according to policy and procedure.
- Participates in and/or provides needed documentation for agency marketing and fundraising efforts including grants.
SERVICE DELIVERY
- Provides oversight for implementing care plans goals related to achievement of nutrition/food security
- Provides nutrition screening and education to clients as well as develops/implements/monitor care plans in conjunction with clients with an emphasis on nutritional goals.
- Provide at-home assessment and volunteer service coordination for Care-a-Van clients as appropriate.