RN Care Coordinator - Community Prevention and Treatment Services (req 100789
Whitney M Young Health
- Albany, NY
- $62,000-72,000 per year
- Permanent
- Full-time
- Utilizes evidence based practice standards, PCMH guidelines, and knowledge of Chronic Illness to provide quality care management for persons living with HIV/AIDS
- Collaborates with providers/clinical teams to identify HIV patient population for care coordination based on quality reports, lab/diagnosis criteria, and provider recommendations.
- Coordinates care for patients receiving HIV and gender affirming care, including assistance with referrals, providing medication education and connecting patients to internal/external services.
- Participates in State and Federal Ryan White Program HIV trainings, conferences, and meetings.
- Participates in HIV related educational events with patients including quarterly Client Advisory Board (CAB).
- Collaborates with members of the HIV team and Quality Improvement Committee-tracking HIV metrics and participates in quality improvement projects related to HIV and gender affirming care.
- Facilitates referrals to behavioral health, substance abuse, specialty care and other community-based resources to address social drivers of health (SDOH).
- Supports patients living with HIV with medication education, community linkage and counseling to achieve and maintain viral suppression
- Participates in HIV clinical meetings with patients across the WYH network of care
- Assists patients across the WYH network of care with linkage to counseling across the HIV care continuum including STI testing, Pre-exposure prophylaxis (or PrEP), and Post-exposure prophylaxis (PEP)
- Collaborates with medical case managers to ensure all patients with HIV are connected to care in a timely manner
- Serves as point of contact for patients requiring assistance with clinical HIV needs and triages needs to other team members as indicated.
- Demonstrates excellence in both internal and external customer service, along with patient engagement
- Understands and effectively communicates HIPAA compliance, corporate compliance and client confidentiality.
- Ensures and remains in compliance with local, state, and federal regulation (FQHC), i.e. DHHS HRSA, CMS guidelines, and NYSDOH (article 28), and all accreditation standards (e.g. Joint Commission and NCQA-PCMH)
- Adheres to the National Patient Safety Goals as defined by the Joint Commission/NCQA and Whitney M. Young Jr. Health Center.
- Completes other duties as assigned