Hep C Care Coordinator

Title: Hepatitis C Care Coordinator

Division: Clinical Services

Department: Community Prevention Services

FLSA Status: Non-Exempt

Reports To: Manager, Hepatitis C and Community Prevention Services

Direct Reports: None

Purpose: Works with Trillium Health staff and outside agencies to promote linkage, retention and treatment adherence of patients infected with hepatitis C, supporting the patient-centered, integrated medical and behavioral model of the Trillium Health's Hepatitis C Program. The Hepatitis C Care Coordinator provides education, testing, treatment adherence services and overall care coordination for patients with Hepatitis C.

Key Job Responsibility Areas

• Clinical Responsibilities

• Care Coordination

• Testing

• Programming

• Administrative Services

• Miscellaneous

Detail of Key Job Responsibility Areas

• Clinical Responsibilities

• Linkage

• Ensures individuals who test preliminary positive for hepatitis C are linked to medical care and have confirmatory testing.

• Provides intake to medical care including opening chart in EMR, filling out releases, assessing for barriers to linkage and retention, records requests and scheduling of appointments.

• Accept and coordinate internal and external referrals for hepatitis C management.

• Orient patients to services available within the agency and to the mission at Trillium Health.

• Patient Education

• Meet with all hepatitis C patients prior to treatment initiation to provide disease specific education, treatment options, review program and expectations of patients on treatment.

• Meet with all patients who complete treatment to provide disease specific education including risk reduction counseling to prevent reinfection.

• Deliver opioid overdose prevention training to patients and facilitate retrieval of naloxone.

• Treatment Adherence

• Meet with all hepatitis C patients prior to treatment to provide treatment adherence education and assess their willingness to adhere to hepatitis C treatment.

• Meet with all patients on hepatitis C treatment to provide treatment adherence education

• Meet with all patients on treatment to complete a quantitative assessment of antiviral adherence.

• Provide support over the phone as needed to remind patients of appointments and/or when to take medications.

• Assist patients with filling pillboxes if needed.

• Work with internal and external pharmacies to ensure medication is available when needed.

• Care Coordination

• Ensure patients are scheduled for appointments as required by the Hepatitis C program.

• Work with the hepatitis C providers to ensure labs and referrals are made as needed and follow-up with patients to ensure they are completed.

• Follow-up with patients who miss scheduled appointments or other requirements of the program.

• Provides referrals to appropriate internal and external resources including, but not limited to: insurance navigator, care management, partner notification, health education, housing, harm reduction services, etc.

• Assists patients in applying for assistance to cover medical visits, laboratory fees and medications. (i.e. NYS HepCAP, Trillium Health's Sliding Fee Scale Program, Patient Assistance Programs for medication coverage, Prior Authorizations through third party payers to medication coverage)

• Function as liaison with internal staff, pharmacies, home care and other community agencies to promote linkage, retention and treatment adherence services for hepatitis C.

• Testing

• Provide Rapid HCV Testing and Dried Blood Spot Confirmatory testing when necessary

• Discuss strategies for risk reduction and assist client in creating a practical risk reduction strategy that is client-centered

• Connect clients to services and care

• Provide condoms and other risk reduction supplies to clients

• Demonstrate developing knowledge of HIV/HCV/STIs, factors affecting people who use drugs, health disparities, and other health-related issues relevant to the mission and vision of Trillium Health

• Document testing services provided as required by funders

• Programming

• Present culturally-competent educational and risk reduction programming and HCV prevention and treatment education to individuals and groups of clients/patients, staff, volunteers, and community members

• Ensure HCV prevention is integrated into programming and outreach programs

• Distribute current and appropriate educational and service materials at outreach events, one-on-one meetings, and programming

• Demonstrate developing knowledge of HCV, priority populations, and other health-related issues

• Learn and implement Evidence-Based Interventions or other structured programming

• Serve as an ambassador of all services of Trillium Health and The MOCHA Center during community-based outreach, education, and testing

• Administrative Services

• Document all services provided as required by funders and protocols

• Enter, compile, and report program data as required by program and/or funder

• Maintain inventory of tools, patient education materials, and incentives

• Participate in 30 hrs of training and continuing education initiatives per year to build understanding of evolving treatment and service delivery issues

• Prepare and participate in monthly meetings to review caseload and quality data with hepatitis C team.

• Participate in Hepatitis C QAPI meetings and perform quality improvement projects and deliverables as needed.

• Assist manager with completion of tasks assigned by Trillium Health Leadership and/or AIDS Institute such as monthly narratives or other documents.

• Miscellaneous

• Maintains a compassionate attitude toward people who use drugs

• Requires the ability and commitment to respect and support inclusiveness and diversity including but not limited to individuals of different backgrounds, cultures, races, ages, sexual orientations, gender identities or expressions, experiences, opinions, etc.

• Requires individual demonstration of commitment to the One Trillium values, behaviors and business impacts and modeling them in the organization.

• Responsible for maintaining confidentiality of all patients, client, employee, protected and proprietary information.

• Employees are accountable for meeting the performance standards of their departments and must participate as requested in compliance audits, process improvement and quality improvement plans.

• Other duties as assigned.

Qualifications

High school diploma and 5 years of related experience; or Associate's Degree and 3 years of related experience; or Bachelor's degree, in Public Health, Psychology, Science, Health Education, Social Work or related field.

Experience in a community health role related to hepatitis C and familiarity with general health guidelines preferred. Experience with community health settings and direct patient care interaction required. Must have excellent communication and teaching skills. Bilingual preferred. Proficiency in word-processing and spreadsheet software required. Must have a valid driver's license and reliable transportation.

Physical Requirements

While performing the duties of this job the employee is required to stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms, talk and hear. Occasionally the employee must stoop, bend and lift or move up to 25 lbs. Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.