Part Time Linkage to Care Manager – HCV (RN)

Part Time Linkage to Care Manager – HCV (RN)
Part Time Linkage to Care Manager – HCV (RN)

Position Status

Part Time


Population Health



Position Days


Hours Per Week


Weekends Required


Reports To

Director of Population Health

Contact Info

Job Description

CompleteCare Health network is looking for a Linkage to Care Manager to join our healthcare team! CompleteCare offers employees the unique opportunity to use their skills to help those most in need of care in the communities we serve. CompleteCare employees are a particularly dedicated group of individuals who care about our patients, the organization, their co-workers as well as their community and work together to further our mission. As a Patient Centered Medical Home, we offer the opportunity to practice in a team-based environment that uses the latest technology to track and manage the health of our patients. If you are someone who wants to make a difference every day, then we want you to join our team!

Our Mission: To improve lives by providing comprehensive, high-quality healthcare to every person in every community that we serve.

Our Vision: CCHN will maintain its position as the leading community health center in the state and become a model for all other healthcare organizations to follow.

Our Values: Quality – Affordability – Accessibility – Cultural Diversity


Major Function: To Focus on management of patients with high risk for and diagnosed with Hepatitis C Virus (HCV) within a team-based, patient-centered medical home model of care. As a member of the HCV Team, the hepatitis linkage to care manager provides direct support in linking Hepatitis C patients to care and treatment. Collaborates with the treating physician and multidisciplinary team, liaises with community partners, and provides related education and support when necessary.

Reports to: Director, Population Health

FLSA Status: Exempt (Salary)

Hours: 20 hours per week, Flexible

Salary: Will commensurate with experience and educational background

Qualifications & Knowledge :

  • Current RN License - unrestricted
  • High school diploma or equivalent
  • BSN preferred
  • Willing to become a member of other professional bodies to enhance practice
  • Minimum of three years’ experience in a clinical setting preferred
  • Community nursing experiences an asset
  • Ability to work independently and interact as a team with physician/ other health care professionals in a professional manner.
  • Self-directed and able to take initiative
  • Experience with chronic illness preferred
  • Knowledge of mental health and addictions preferred
  • Familiar with principles of adult education
  • High level of comfort with diverse populations
  • Strong decision-making skills
  • Excellent communication skills
  • Able to assess medical conditions, and to know when to seek assistance
  • Ability to work in an evolving role
  • Basic level of proficiency in Microsoft Office suite applications (Word, Excel, Outlook/Email, Internet), including the ability to type and talk at the same time and toggle between multiple applications
  • Strong commitment to CompleteCare’s mission
  • Bilingual a plus (Spanish/English)


  • Navigate new and existing HCV Antibody positive patients to on-site viral load/confirmatory testing
  • Follow-up with all HCV Antibody positive patients screened for post-test counseling and basic HCV-related education: natural history, prevention of transmission, evaluation, and treatment
  • Accept and coordinate in house and outside HCV referrals from primary care physicians
  • Schedule patients for all appointments including first on-site HCV evaluation with on-site HCV specialist (within one week), treatment meetings, and follow up appointments on-site and off-site
  • Remind patients one day prior to appointment and check to see if patients adhered to appointment
  • Promote adherence to all HCV-related appointments and send correspondences for patients lost to follow-up
  • Obtain outside medical records as needed
  • Work closely with on-site HCV primary care champion to ensure patients are engaged with HCV care (e.g. weekly HCV clinics, review case load, and review data requirements)
  • Follow up on labs ordered by the Hepatitis C provider and review results to complete evaluation
  • Check in with patients while on treatment after appointment with on-site HCV primary care champion:
  • assess how patient is doing (build rapport)
  • ask patient to clarify next steps
  • schedule follow-up appointments in real-time (e.g. ultrasound)
  • elicit fears and concerns
  • answer questions
  • work with any insurance issues and refer to on-site Medicaid office or on-site social worker
  • Work with CompleteCare’s Specialty pharmacies for ordering/delivering HCV-medications.
  • Prior authorizations for HCV medications, adjuvant medications and other related-procedures
  • Assess patient adherence to medications; counsel patients; and review/monitor for drug-drug interactions
  • Provide adherence counseling and assist with side effect management via weekly calls
  • Conduct brief alcohol and mental health screenings and/or interventions
  • Pre-treatment readiness assessments to identify potential barriers to treatment (e.g. using standardized instrument such as PREP-C, reaching out to patient’s primary care provider)
  • Provide HCV education (evaluation, treatment, adherence, and side effect management)
  • Work with outside labs for uninsured patients in need HCV viral load testing
  • Collect all HCV-related data and input in timely manner within databases
  • Maintain all HCV-related databases (e.g. updating data daily, ensuring data security)
  • Attend on-site and off-site trainings as needed.
  • Work at multiple clinics in various locations throughout the week
  • Work closely with community to develop and maintain HCV-related networks (e.g. syringe exchange program and CBOs)
  • Collaborate with HCV team members in dissemination activities (abstracts and papers)
  • Other duties as needed