Department: Clinical Services / Population Health
Reports To: Program Manager
FLSA Status: Non‑Exempt
Position Type: Full‑Time

Position Summary

The Outreach Coordinator supports patient engagement, linkage to care, and retention efforts for primary care adult and pediatric patients as well as individuals enrolled in the Ryan White HIV/AIDS Program at a Federally Qualified Health Center (FQHC). The position focuses on community‑based and clinic‑based outreach, education, and care coordination to reduce barriers to care, improve access, and support health equity. The Outreach Coordinator works closely with clinical teams, care coordinators, and community partners to connect patients to needed services and resources.

Essential Duties and Responsibilities

Outreach and Engagement (Primary Care & Pediatrics)

Conduct outreach to patients and families to promote access to primary care services, preventive care, and follow‑up appointments
Engage adult and pediatric patients through clinic‑based outreach, phone calls, community events, and partnerships
Provide education on available health center services and assist patients with navigating care
Support appointment adherence by conducting reminders, follow‑ups, and re‑engagement for missed visits
Identify and address non‑clinical barriers to care, including transportation, language access, and health system navigation

Ryan White HIV/AIDS Program Outreach

Conduct targeted outreach to Ryan White eligible clients to support linkage to HIV medical care, retention, and re‑engagement
Work collaboratively with Ryan White medical case managers and providers to support continuity of care
Assist with patient education related to Ryan White services, eligibility, and available support services
Support outreach strategies that promote engagement, viral suppression, and health outcomes
Document outreach activities in compliance with Ryan White program requirements and funding guidelines

Care Coordination and Community Partnerships

Coordinate referrals and warm handoffs to internal departments and external community‑based organizations
Maintain strong working relationships with community partners, social service agencies, and support programs
Participate in care team meetings, huddles, and case discussions as appropriate
Assist with distribution of educational materials and approved patient support items, as applicable

Documentation, Data, and Compliance

Document outreach and engagement activities accurately and timely in the electronic health record (EHR) and applicable tracking systems
Support data collection and reporting requirements related to Ryan White, primary care, and grant‑funded activities
Adhere to confidentiality, HIPAA, and Ryan White privacy requirements
Assist with monitoring outreach outcomes and identifying opportunities for improvement

Required Qualifications

High school diploma or equivalent required; Associate’s or Bachelor’s degree in public health, social services, health education, or related field preferred
Experience working in a healthcare, community health, or social services setting
Experience working with underserved or vulnerable populations
Strong interpersonal, communication, and organizational skills

Knowledge, Skills, and Abilities

Understanding of community outreach, patient engagement, and care coordination
Ability to work effectively with diverse populations and maintain cultural sensitivity
Strong verbal and written communication skills
Ability to work independently and as part of a multidisciplinary team
Proficiency with electronic health records and basic computer applications
Ability to maintain confidentiality and comply with program and regulatory requirements

Preferred Qualifications

Experience working with the Ryan White HIV/AIDS Program
Knowledge of HIV care continuum, social determinants of health, and community resources
Bilingual (Spanish or other languages commonly spoken in the service area)
Experience conducting outreach in community‑based settings

Working Conditions

Combination of clinic‑based and community‑based work
May require local travel for outreach activities
Flexible schedule may be required to support outreach events or patient needs

Greater Baden Medical Services, Inc.

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