Patient Navigator (SCL)

• Serve as a primary point of contact for clients seeking mental health and supportive counseling services.
• Conduct client intakes, needs assessments, and care plans.
• Develop and maintain up-to-date risks assessment, linkage to care, treatment adherence assessments.
• Provide education, emotional support, and advocacy to individuals with HIV/AIDS navigating behavioral health care.
• Support clients in adhering to their treatment plans and medical care.
• Schedule clients for office/home visits to conduct assessments, individual counseling, service plan updates, wellness checks, and/or reassessments.
• Provide ongoing support to encourage retention of services.
• Conduct re-engagement activities via a series of phone calls, written correspondences, and/or in person visits to the client’s place of residence.
• Create a safe and professional and welcoming environment for clients of the priority population.
• Provides home, hospital, or community site visits and escorts patients to medical and non-medical appointments, as indicated and as approved by the Clinic Supervisor and/or Clinic Director.
  
  

• Reviews referrals and assesses patients for individual services.
• Identify supportive services that will benefit the health and well-being of the client and effectively refer them to necessary services.
• Assist clients in accessing mental health services, primary care, substance use treatment, housing support, and other community resources.
• Develop strong partnerships with healthcare providers, service providers, and community-based organizations.
• Support appointments adherence through accompaniment, referring, scheduling and re-scheduling assistance.
• Identify supportive services that will benefit the health and well-being of the client and effectively refer them to necessary services.
• Develops, implements, and reassesses care plans to address barriers to expected health outcomes and self-management and to address patient needs and assure continuity of care.
• Collaborate with and consult with other team members in identifying services gaps and needs.
• Attend community events and health fairs to build community partnerships.
• Facilitate warm hand-offs and follow-up to ensure continuity of care.
  
  

• Provide HIV/AIDS education and promote engagement in treatment and adherence strategies.
• Educate clients on mental health wellness, harm reduction, and self-care techniques.
• Facilitate individual counseling, support groups and workshops on behavioral health and wellness topics.
• Educate clients on life skills such as budgeting, food shopping, health living, physical and mental health well-being.
  
  

• Identify and address barriers to care such as stigma, homelessness, food insecurity, or lack of insurance.
• Assist clients in navigating Medicaid, ADAP, HOPWA, Other Ryan White programs, and other assistance programs.
• Support clients experiencing crises by connecting them to appropriate mental health or emergency services.
• Support clients experiencing crises by connecting them to appropriate mental health or emergency services.
• Advocate for clients in healthcare settings and with social service agencies.
  
  

• Maintain accurate and timely records in Electronic Health Records (EHR) and other required databases in accordance with agency protocols and standards.
• Document each encounter with each client via accurate progress notes.
• Ensure compliance with confidentiality laws (HIPAA) and funder requirements.
• Attend and participate in Quality Improvement and Performance Improvement teams and tasks.
•  Participate in program meetings, trainings, and client case conferences.
• Ensure adherence to client confidentiality procedures as governed by HIPAA and HCC confidentiality policies and procedures.
• Attends required meetings, conferences, supervision, trainings, and professional development.
  
  

•  Bachelor’s degree in Public Health, Psychology, Human Services, or a related field preferred.
• Associate degree with at least 2 years of experience in health navigation, case management, peer advocacy, or HIV/AIDS services considered.
•  Experience working with People Living with HIV/AIDS (PLWHA), LGBTQ+ communities, and individuals with mental health/substance use disorders.
• Knowledge of harm reduction, trauma-informed care, and motivational interviewing preferred.
• Cultural competency in working with diverse populations, including BIPOC, LGBTQ+, and immigrant communities.
• Strong interpersonal and excellent verbal and written communication skills.
• Ability to work independently and collaboratively in a team setting.
• Organizational and problem-solving abilities to assist clients with complex needs.
• Demonstrate strong organizational skills, attention to detail, teamwork skills, and ability to work in a fast-paced and demanding work environment.
• Knowledge of community resources as pertinent to social determinants of health (e.g. housing, food access, transportation, etc.)
• Effective client engagement and needs assessment skills.
• Experience on NYC health and human services systems, processes, and services.
• Competency in Microsoft applications including Word, Excel, and Outlook.
• Language Proficiency (English/ Haitian Creole, French and/or Spanish,) preferred.
• Must be able to pass a background check.
• Passion for HCC’s mission.