Department Description:

ABOUT WARD 86 CLINIC

Ward 86, the HIV/AIDS Clinic at the Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) campus has been a leader and innovator in field of HIV care since the beginning of the epidemic. Ward 86 is the largest clinic providing primary medical care for people living with HIV for the San Francisco Health Network (SFHN) and also provide preventive services to patients at-risk for HIV infection, including pre-exposure prophylaxis (PrEP). Ward 86 provides care to approximately 2500 patients living with HIV, with over 24,000 clinical encounters a year. Services are offered through a comprehensive, multi-disciplinary approach, addressing primary medical and HIV care, urgent care, mental health evaluation and treatment, substance use assessment, treatment and referrals, HIV prevention services, and HIV specialty care needs (including on-site Pulmonary, Dermatology and Cardiology clinics), and psycho-social assessment and interventions.

Job Summary:

Providing supportive linkage to health care services and rendering dedicated and ongoing assistance to patients to stay engaged in HIV care, are important interventions to improve overall health outcomes of people living with HIV and patients who are at risk of HIV acquisition. Both patients who are newly diagnosed with HIV and patients who are entering a health system benefit from enhanced and individualized support while linking and engaging with a health care system. As strong engagement in both HIV care and preventative services has been shown to improve health outcomes, patients with HIV and those at risk of HIV acquisition will continue to need support and guidance to optimize health outcomes.

The HIV and Prevention Care Coordinator plays a critical role, working closely with clinical care teams in order to assist patients in obtaining timely, essential, and appropriate HIV and preventative medical and psychosocial services to optimize health outcomes and prevent HIV acquisition for patients at risk of HIV acquisition. The HIV and Prevention Care Coordinator will work closely with clinical teams to assist patients with linkage to care, provide engagement interventions for patients who are at risk of falling out of care, assist with navigation of patients to care, provide adherence counseling, conduct follow-up outreach in person, by phone, or other electronic means, and liaison with clinical service providers to address specific health concerns. Other contributions will include assisting with the development, modification, and implementation of HIV care and preventative protocols, reviewing patient charts, and entering/tracking patient data via electronic health records and other data systems. The HIV and Prevention Coordinator will perform work at the ZSFG Campus and in the community within the City and County of San Francisco.

We strongly encourage candidates who hold ethnically, culturally, and sexually diverse identities to apply.

% of time	Essential Function (Yes/No)	Key Responsibilities (To be completed by Supervisor)
65%	Yes	Establishes and coordinates a supportive plan with goals and interventions based on individual patient and health care provider needs. Recommends changes or new processes to increase patient satisfaction in navigating across the healthcare system for services. Works closely with clinical care team to assist patients in obtaining timely, essential, and appropriate medical and social services to optimize health and prevent HIV acquisition. Coordinates intake appointments for patients who are new to the health system, including facilitating collaboration between patient, eligibility staff, and health care providers. Assists providers with identifying patients who are at risk of HIV acquisition and patients who are at risk of falling out of care. Works closely with clinical teams, advocates and represents the patient with a focus on the patient’s satisfaction with the clinical aspects of their treatment experience. Identifies and works to remove barriers to the plan of care as appropriate. Follows up with patients and families using established escalation and triage protocols. Documents to standards. Assists with developing/refining of protocols and participates in documentation improvement activities. May provide guidance on the ongoing monitoring and adherence counseling of patients. Locates and meets patients in the community and partners with patients and clinical teams to support linkage to HIV and preventive services at ZSFG and other sites within the San Francisco Health Network (SFHN).
30%	Yes	Coordinates referrals for medical and psychosocial services both within health system and outgoing referrals. This may include coordination in obtaining prior authorizations Coordinates clinical and non-clinical resources based upon patient's medical diagnoses, insurance coverage, and community programs. Applies knowledge to explain care options. Identifies patient's preferences, and any barriers to treatment plan implementation. Consults with patients to answer questions about HIV care engagement and preventative services, assists with establishing medical insurance coverage, makes and facilitates access to medical and psychosocial services May provide adherence counseling for patients on PrEP, prepares orders and monitor test results per protocol, conducts follow-up phone calls, works to re-engage patients lost to follow-up via established methods, evaluates adverse effects and communicates assessment findings and concerns to health care teams. Anticipates and initiates coordination activities; develops plans for patients to set expectations and coordinates care in alignment with patient's needs. May include reviewing clinical cases with health care team to schedule services.
5%	Yes	Assists with collecting, evaluating, and presenting meaningful use and/or relevant operational or clinical data to leadership. Establishes recommendations for follow up and action plans for improvement in clinical services. May participate in analyzing patient satisfaction reports and metrics regarding clinical treatment and patient understanding of their care plan. Pro-actively identifies problems in processes and clinical operations affecting patient satisfaction. Collaborates with clinical team to develop improvement processes to increase patient satisfaction. Assists in developing a culture oriented around patient satisfaction. Participates in relevant committees, task forces, coalitions, associations, and meetings to represent the clinic and the patients as assigned. May participate on teams for improvements in clinical applications, in conjunction with workflows. Assists and supports onboarding new staff to the workflows and processes; trains in new technologies. Reports issues to appropriate provider and/or department manager. Solicits feedback on patient/family interactions/style/efficacy from peers and managers. Performs other duties as assigned.

Required Qualifications:

Bachelor's degree in related area and three or more years of relevant experience and / or equivalent experience / training
Strong knowledge of Patient Rights & Responsibilities, Joint Commission standards, and Centers for Medicare / Medicaid regulations. Knowledge of Medical Terminology. Strong knowledge of data collection, compilation, and analytical techniques
Strong skills to comprehend and assess patient's grievances to quickly locate appropriate resource for assistance. In-depth knowledge of the organization and how to get issues resolved
Excellent customer service skills, working with a high volume and high expectations customer base. Ability to support patients with a wide variety of clinical and non-clinical needs
Ability to work in a complex, multi-divisional environment with the skills to establish priorities, set objectives and achieve stated goals. Ability to utilize project management tools. Excellent analytical and problem-solving skills
Clear and concise communication skills to teach patients about complex, sensitive clinical issues
Proficiency with Windows-based software including Microsoft word, Excel, Outlook. Knowledge of computer systems and software used in functional area
Experience working with ethnically, culturally, and sexually diverse populations
Bi-lingual English/Spanish or English/Cantonese (speaking, reading, and writing)
Ability to travel and work among various clinics within San Francisco
Ability to work independently and as a team member
Strong organizational skills and attention to detail
Excellent oral and written communication skills

Preferred Qualifications:

Experience working with people living with chronic illness, substance users, or persons with mental health diagnoses
Knowledge of HIV/STD treatment and prevention with a focus on harm reduction
Work experience in a health care organization
Ability to learn Electronic Medical Records (EMR), disease registry and other information systems in a short time frame
California HIV Test Counseling Certification

PAT NAVGTR NON-CLIN III CX

Job Description

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