Community Outreach Navigator

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The Community Outreach Navigator under the direction of the ETE Senior Advisor plays a critical role in providing support, guidance, and advocacy to individuals living with HIV. This role is primarily responsible for communitybased engagement through home visits, health facility outreach, and collaboration with healthcare providers and community partners to re-engage patients in care and improve health outcomes.

9:00 A.M – 5:00 P.M

• Conduct home, hospital, or community field visits to locate members who are lost to care or at risk of disengaging from care.
• Engage patients in their homes, community locations, or healthcare facilities to assess barriers to care and support re-engagement with primary care services including accompaniment to medical or non-medical appointments.
• Provide health coaching and motivational support to empower members in staying connected to HIV primary care and treatment.
• Collaborate with healthcare providers, care managers, and community organizations to coordinate services that address member needs.
• Schedule medical appointments, arrange transportation, and facilitate medication access to remove barriers to care.
• Track all medical, behavioral, and other referrals ensuring members attend appointments, through reminder calls and accompaniment when necessary.
• Monitor utilization including ER visits, hospitalization admission/discharge information, and behavioral health services to find opportunities for engagement with members.
• Document outreach efforts, patient interactions, and care coordination activities in the appropriate case management systems.
• Build trusting relationships with patients from diverse backgrounds using culturally sensitive and strengths-based approaches.
• Participate in case conferences, training sessions, and quality improvement initiatives.

• Associate’s degree with 3 years of professional experience in care coordination, health education, or case management required; OR
• High school diploma/GED and 6 years’ experience in care coordination, health education, or case management required.
• Experience working with vulnerable or marginalized populations, including a strong knowledge of HIV.
• Field work experience is preferred.
• Frequent travel within the community is required.
• Must be comfortable conducting home visits and outreach in diverse settings.
• Must be able to navigate NYC by mass transit.
• Bilingual proficiency (English/Spanish or other languages) is highly desirable.
• Occasional evening or weekend work may be required.

Professional Competencies

• Strong interpersonal and communication skills to build rapport with patients and care teams.
• Ability to navigate community settings and conduct face-to-face outreach.
• Effective problem-solving and organizational skills.
• Knowledge of community resources and healthcare systems.
• Proficiency with Microsoft Office and electronic health record systems.
• Culturally competent approach to patient engagement.

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• Loan Forgiveness Programs for eligible employees
• College tuition discounts and professional development opportunities
• College Savings Program 
• Union Benefits for eligible titles 
• Multiple employee discounts programs
• Commuter Benefits Programs

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