Care Coordinator

ZUFALL HEALTH CENTER INC
Somerville, NJ

Job Description

Job Description

Description:

Under the direction of the Prevention and Retention Program Manager (PRPM), the HIV Care Coordinator (CC) , with a focus on Non-Medical Case Management (NMCM) and Linkage/Retention in care, shall provide linkage and support services to any newly diagnosed HIV positive patient(s) and reengagement of out of care positive patients. The CC is responsible for providing a trust-based, supportive coordination of care to Ryan White program participants. The CC is responsible for managing an assigned case load, providing case management assistance to team members from all HIV programs. The CC will collaborate with the outreach team to coordinate education and testing services. Under the PRPM, the CC will co-facilitate support services and conduct outreach visits/testing events. The CC will work directly with the PRPM to help create and implement a plan helping Zufall work towards ending the HIV epidemic. The CC will maintain up to date knowledge regarding HIV, resources, services, PrEP and other initiatives. The CC will work in collaboration with the RW team to improve overall services. The CC will maintain accurate records of all patients encounters and submit reports monthly. The CC will participate in meetings, trainings, staff development and any other duties as Assigned.

Essential Functions, Duties and Responsibilities

  • Welcomes and educates new patients on ZHC/grant requirements for care, the process of operation(s) and what to expect from the program
  • Provides assistance for the RW team by meeting patients at appointments to medical, mental health, substance abuse treatment or social service programs to improve attendance if needed, helping to support patients to be independent and on the importance of remaining engaged in care
  • Schedules, coordinates and facilitates program appointments, provides linkage to care and assists with verification of documents. Follows up with outside resources and services for maintaining treatment adherence
  • Helps facilitate ADDP applications, program specific assessments and reassessments and HIPP if applicable
  • Provides education and HIV testing to the community within the health centers and at outreach and special activities
  • Provides supervisor with information needed for end of month reporting and/or participates in program evaluation as requested/assigned by the provider
  • Demonstrates appropriate behavioral boundaries including treating persons with respect, abide by the code of conduct expected of Zufall employees, and be respectful of co-workers
  • Maintains a high level of patient confidentiality in accordance with HIPAA and ZHC policies
  • Other duties as assigned by the supervisor

Requirements:
  • Bachelor’s degree in social work, public health or related field required, or a combination of education and experience in lieu of a bachelor’s degree
  • Must have knowledge of HIV and related services, including case management. If HIV positive, there is no need to divulge status to clients or staff
  • Knowledge of and/or successful completion of trainings in HIV/AIDS testing, education, trauma informed care and stigma
  • A current, valid and unrestricted driver’s license for the state of NJ
  • Working knowledge of Windows-based computer, Microsoft Office and Outlook
  • Reliable personal transportation
  • Familiarity with HIV/AIDS, substance use, and mental health issues
  • Ability to work collaboratively as a part of a team in a clinical and non-clinical setting, with excellent interpersonal communication
  • Bilingual (Spanish) preferred
  • Excellent oral and written skills, strong communication skills, problem solving, teamwork and organizational skills
  • Ability to work with multicultural and diverse population is required
  • Must be self-motivated, detail oriented, able to travel locally and work flexible hours.
  • Learn and apply the trauma informed care principles within the scope of the incumbent’s position
Posted 2025-07-29

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