Hep C Care Coordinator

Department: Community Prevention Services

Position Type: Full-Time

FLSA: Non-Exempt

Job Summary:

Join us and be a part of Trillium—a mission driven team committed to expanding access to high quality, compassionate care for everyone we serve. The Hepatitis C Care Coordinator works collaboratively with Trillium Health staff and outside agencies to promote linkage, retention, and treatment adherence for patients infected with hepatitis C, supporting Trillium Health’s patient-centered, integrated medical and behavioral model within the Hepatitis C Program. The Hepatitis C Care Coordinator provides education, testing, treatment adherence services, and overall care coordination for patients with Hepatitis C. 

Duties/Responsibilities:

Linkage

• Ensure individuals who screen preliminary positive for hepatitis C are linked to medical care and receive confirmatory testing.
• Provide intake to medical care including opening charts in the EMR, completing releases, assessing barriers to linkage and retention, coordinating records requests, and scheduling appointments.
• Accept and coordinate internal and external referrals for hepatitis C management.
• Orient patients to available services within Trillium Health and to the organization’s mission. 

Patient Education

• Meet with all hepatitis C patients prior to treatment initiation to provide disease‑specific education, review treatment options, and outline program expectations. 
• Meet with patients completing treatment to provide education on hepatitis C and risk‑reduction counseling to prevent reinfection. 
• Deliver opioid overdose prevention training and facilitate access to naloxone. 

Treatment Adherence

• Meet with all hepatitis C patients prior to treatment to provide adherence education and assess readiness to engage in treatment. 
• Meet with patients on treatment to provide continued adherence education and support. 
• Complete quantitative assessments of antiviral adherence for patients receiving treatment.
• Provide telephone support to remind patients of appointments or medication schedules.
• Assist patients with pillbox setup when needed. 
• Collaborate with internal and external pharmacies to ensure medication is available when needed.

Care Coordination

• Ensure patients are scheduled for all appointments required by the Hepatitis C Program.
• Collaborate with hepatitis C providers to ensure laboratory tests and referrals are ordered and completed.
• Follow up with patients who miss appointments or other program requirements.
• Provide referrals to appropriate internal and external resources, including insurance navigation, care management, partner notification, health education, housing, and harm‑reduction services.
• Assist patients with applications for coverage of medical visits, laboratory fees, and medications (e.g., NYS HepCAP, Trillium Health Sliding Fee Scale, patient assistance programs, and prior authorizations through third‑party payers).
• Serve as liaison with internal staff, pharmacies, home care services, and community agencies to promote linkage, retention, and treatment adherence.

Testing

• Provide rapid hepatitis C testing, dried blood spot confirmatory testing, and Gene Xpert Cepheid testing when necessary.
• Discuss risk‑reduction strategies and assist clients in developing practical, client‑centered risk‑reduction plans. 
• Connect clients to services and care.
• Provide condoms and other risk‑reduction supplies.
• Demonstrate developing knowledge of HIV, HCV, STIs, substance use‑related factors, health disparities, and other health‑related issues relevant to Trillium Health’s mission and vision.
• Document testing services as required by funders.

Programming

• Present culturally competent educational and risk‑reduction programming and hepatitis C prevention and treatment education to clients, patients, staff, volunteers, and community members.
• Ensure hepatitis C prevention is integrated into outreach and programming activities.
• Distribute current and appropriate educational and service materials during outreach, one‑on‑one encounters, and programming.
• Demonstrate developing knowledge of hepatitis C, priority populations, and related health issues.
• Learn and implement Evidence‑Based Interventions and structured programming.
• Serve as an ambassador of all Trillium Health and The MOCHA Center services during community‑based outreach, education, and testing.

Administrative Services

• Document all services provided in accordance with funder and program protocols.
• Enter, compile, and report program data as required by program and funders.
• Maintain inventory of tools, patient education materials, and incentives.
• Participate in a minimum of 30 hours of training and continuing education annually.
• Prepare for and participate in monthly meetings to review caseload and quality data with the hepatitis C team.
• Participate in Hepatitis C QAPI meetings and complete quality improvement initiatives as assigned.
• Assist the Manager with tasks requested by Trillium Health leadership and/or the AIDS Institute, including monthly narratives and required documentation.

Miscellaneous:

• Requires the ability and commitment to respect and support patients, other employees and visitors with various lived experiences.
• Requires individual demonstration of commitment to the mission, vision, One Trillium values, behaviors and modeling them in the organization.
• Responsible for maintaining confidentiality of all patient, client, employee, protected and proprietary information.
• Employees are accountable for meeting the performance standards of their departments and must participate as requested in compliance audits and quality improvement plans.
• Required to participate in continuous improvement of job responsibilities and organizational or work processes to advance the organization or department. 
• Other specific duties as assigned.

 Required Skills/Abilities: 

• Experience in a community health role related to hepatitis C and familiarity with general health guidelines preferred.
• Experience in community health settings with direct patient care interaction required.
• Excellent communication and teaching skills.
• Bilingual preferred.
• Proficiency in word‑processing and spreadsheet software required.
• Valid driver’s license and reliable transportation required.

Education and Experience: 

• Applicants must meet one of the following:
• High school diploma and five (5) years of related experience; or
• Associate’s degree and three (3) years of related experience; or
• Bachelor’s degree in Public Health, Psychology, Science, Health Education, Social Work, or a related field.

Physical Requirements:

While performing the duties of this job, the employee is required to stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms; talk; and hear. Occasionally the employee must stoop, bend, and lift or move up to 25 lbs. Vision requirements include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. 

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.