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Linkage to Care Coordinator

Posted: 05/21/2023

Who We Are

Vivent Health is one of the nation’s largest providers of HIV prevention, care and treatment services with a budget approaching $260 million and employing over 550 professionals.

The unique, nationally recognized Vivent Health HIV Medical home model of care assures that everyone with HIV has access to medical, dental, mental health and social services and provides the best opportunity for patients to achieve high quality health outcomes. Vivent Health also provides aggressive HIV prevention services to gay men, injection drug users and others at the highest risk for HIV infection.

Vivent Health currently operates in multiple states nationwide. It embraces a Market Culture to increase access to care, enhance quality outcomes, achieve and surpass financial performance expectations and has an aggressive plan to expand into additional states.

Position Description

The Linkage to Care Coordinator is a specialty position with a focus on working with individuals who are newly diagnosed with HIV/AIDS and/or new to the area and needing help with "linking" to care. 

This position provides case management services under the framework of the Missouri Department of Health, Bureau of HIV/AIDS Care and Prevention Services and the Kansas City Health Department HIV Care.


  • Conducts a comprehensive culturally sensitive assessment with the client and/or family/support network.
  • Develops with the client and/or family a mutually agreed upon plan of care to meet the needs of the client as identified in the assessment. The plan must be action-oriented and time-specific.            
  • Arranges and coordinates multiple services for the client and/or family. Provide ongoing monitoring of the activities implemented to carry out the plan of care.
  • Evaluates the effectiveness of the plan of care in achieving the desired outcomes with clients and/or families, the treatment team and external service providers. 
  • Maintains regular contact with clients to provide ongoing assessment, support, intervention and satisfaction of services.  As this is a short-term intensive case management program, contact will be made weekly for the first 6 weeks of engagement in Linkage to Care then contact will gradually decrease to one time per month. This includes timely follow-up with client plan of care (goal/service plan) as documented in client file (SCOUT Service Plan).
  • Maintains current knowledge of medical and psycho-social developments concerning AIDS and related conditions.  
  • Provides specific education to specialty clients (newly diagnosed or returning to medical care) regarding coping and acceptance of new diagnosis, navigation of health care system, and HIV education
  • Attend medical appointments with clients per program directives or more often at request of client. 
  • Provides supportive counseling to the client and/or family relative to HIV/AIDS.
  • Negotiates and advocates for the development and delivery of needed services with internal and external service providers.
  • Assists in developing and planning community, region or statewide client services; participates in monitoring such services to ensure proper service delivery.
  • Collaborates as team member to achieve organizational and department goals including participation in rotating on call coverage (during and after business hours) as well as coverage at Kansas City Health Department. 
  • Maintains manual and computerized documentation in the client record
  • Performs other duties as assigned.
Required Qualifications:
  • BSW/MSW/RN or possess a college degree in a related field with two years case management experience.
  • Experience working with individuals of diverse cultures, ethnicities, socioeconomic backgrounds, sexual orientations, and gender identities and/or expressions preferred
Required Experience and Skills:
  • Ability to use professional skills and knowledge to handle crisis situations, assess complex needs, and develop individualized plans of care for patients and clients of all acuity levels.
  • Ability to establish and maintain effective working relationships with culturally diverse populations from a wide range of life circumstances and backgrounds.
  • Demonstrated effective written and verbal communication skills, including client-centered communication and assessment skills.
  • Ability to effectively organize work products and files, keep clear records, and manage time well so as to optimize efficiency and productivity.
  • Knowledge of and sensitivity to the HIV/AIDS patient population, and/or an eagerness to learn about this community.
  • Adheres to all agency policies including, but not limited to, Employee Handbook, Confidentiality, Healthcare Corporate Compliance Plan, Standards of Conduct, and other policies.
Additional Requirements:
  • Reliable transportation to respond to client needs and attend medical appointments. 
  • Ability to work on call hours (rotated among team of 7) that occur on evenings, weekends, and occasional holidays.
Additional Preferred Experience:
  • Minimum of two years’ experience offering direct client service in a community based social service or health care agency.
Additional Preferred Qualifications:
  • Extensive knowledge of HIV disease and related issues, disease progression, and treatment options.
  • Extensive knowledge of medical, social and mental health delivery systems.
  • Working knowledge of Spanish language or other languages (bilingual) is a plus. 
To apply: Email cover letter and resume to Clint Blair, Talent Aquisition Lead. All opportunities are also available to view on our website and you can apply directly there if you prefer. 

Job Type: Full Time