Outreach Coordinator - Street Medicine (Lakewood)

POSITION SUMMARY

MLKCH is seeking an Outreach Coordinator / Street Medicine to be part of our MLKCH Street Medicine program. The Outreach Coordinator will be responsible for helping patients navigate and access community services, other resources, and adopt healthy behaviors. The Outreach Coordinator supports providers and other team members through an integrated approach to care management and community outreach mainly in homeless encampments. As a priority, the Outreach Coordinator will engage in activities that will promote, maintain, and improve the health of unhoused patients. The -Outreach Coordinator provides social support and informal counseling, and advocates for homeless individuals and community health needs. The ideal candidate is someone who is familiar with navigating homeless encampments and interacting with people experiencing homelessness

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Responsible for establishing trusting relationships with patients while providing general support and encouragement.
• Provide ongoing follow-up, basic motivational interviewing and goal setting with patients / families.
• Provide follow-up with patients via phone calls, home visits and visits to other settings where patients can be found.
• Assist patients with completing applications and registration forms. Conduct insurance eligibility determination, enrollment and follow-up with uninsured patients.
• Help patients set personal goals, and attend appointments. Provides referrals for services to community agencies as appropriate.
• Help patients connect with transportation resources and give appointment reminders in special circumstances. Transporting patients is strictly prohibited.
• Exhibit excellent working relations with unhoused patients, visitors and staff, effectively communicating Street Medicine's mission.
• Work closely with medical providers and Manager of Street Medicine to help ensure that patients have comprehensive and coordinated care. Follow-up with patients should be continuous from initial identification through closure.
• Work cooperatively with other clinical personnel assigned to the same patient and ability to collaborate with peers on the Street Medicine team
• Be knowledgeable about community resources appropriate to needs of patients / families.
• Be responsible for providing consistent communication to the rest of the Street Medicine team to evaluate patient.
• Act as a patient advocate and liaison between the patient and community service agencies (i.e. Department Human Services, Heath Care for Homeless, hospitals, support groups, etc.).
• Record patient care management information in the EMR (training provided) and other software
• Attend regular staff meetings, trainings and other meetings as requested.
• Manage assigned caseload of 15 patients.
• Complete Housing Assessment and Individualized Housing Support Plan for patients enrolled in CalAIM.
• Determine location of neighborhoods to be canvassed. Plan routes to be walked in various neighborhoods and routes to be driven between walks to minimize travel time and distance.
• Walk door-to-door and talk with residents. Ask screening questions and compile information about neighborhood, residents and potential patients.
• Train new employees as assigned.
• Serve as primary person within Street Medicine team that advises on safety of team members and visitors when out in field and also understands the value of allowing other clinical and non-clinical team members to voice and address safety concerns.
• Perform other duties as assigned or requested.

POSITION REQUIREMENTS

A. Education

B. Qualifications / Experience

C. Special Skills / Knowledge

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