AmeriCorps Member – Retinopathy Outreach Coordinator; West Region

Overview

Healthy Communities is CHC’s Public Health Ameri Corps program designed to create cohesion in vulnerable communities and to promote healthcare and support services through outreach, awareness, linkage to care and support. Healthy Communities also serves to identify the unique and integral needs of our communities and neighborhoods and to establish strategic plans to address them. Service delivery will directly address the public health crisis in vulnerable communities and make healthcare and support services accessible through flexible delivery of services.

Ameri Corps members will conduct community outreach, education, patient engagement, and link patients to CHCI care and referrals to community based assistance. Additionally, Ameri Corps members will participate in statewide and local activities which promote awareness of health and health services.

This is an Ameri Corps Member role – Retinopathy Outreach Coordinator – that supports the Population Health Department and Clinical Teams in CHC’s West Region (Stamford, Norwalk, Danbury, Meriden, Waterbury and Bristol).

• Conduct monthly patient health education workshops; monitor the completion of pre-post surveys by workshop participants; and complete data entry for workshops and surveys.
• Track and document all completed patient engagement activities in patient’s electronic health record.
• Serve as “Super User” on retinopathy cameras to be teach and monitor organization site users.
• Coordinate with Business Intelligence (BI) to identify patients diagnosed with diabetes who have not had a retinopathy screening.
• Schedule patients for retinopathy screening and potentially other appointment to aid in diabetic care.
• Conduct introduction, retinopathy screening and patient education for high risk patients at in-person appointments.
• Provide outreach and care coordination to patients to aid in elimination of barriers to retinopathy screening.
• Document screening results as well as complete referrals and telephone encounters (TE) as required to facilitate appropriate follow up when indicated.
• Provide support in acquiring documentation of outside exams to comply with PCMH+ goals.
• Coordinate with Population Health Program Manager and Retinopathy Manager to identify other high need areas that may be screened during patient visits and/or phone calls.
• Coordinate with Population Health Program Manager and Retinopathy Manager to create opportunities for additional engagement with high risk patients.
• Promote outreach and engagement with high risk populations at sites within region to include the creation of promotional content for screenings as well as patient education materials/pamphlets.
• Participate in outreach and engagement activities, community events and find methods of promoting care and services to patients who need it.
• Serve with Quality Management (QM) team to identify areas of weakness and assist in the design of a process for routine retinopathy screening for patients who need it.
• Participate in Population Health meetings, Clinical Team and Nurse Manager meetings as directed by supervisor.
• Participate in Performance Improvement Committee Meetings and assist in monitoring follow up on action items retinopathy screenings and diabetes.

• Work with teams to ensure continued outreach and engagement with high risk populations, including creating promotional content for screenings and patient education materials.
• Engage in outreach activities, community events, and promotion of care and services to patients who need them.
• Collaborate with the QM team to identify weaknesses and help design processes for routine retinopathy screening.
• Attend Population Health meetings and Clinical Team/Nurse Manager meetings as directed.
• Participate in committee activities and assist in monitoring follow up on retinopathy screenings and diabetes actions.

• High school or equivalent required
• Proficiency in Microsoft office and internet-related applications
• Excellent time management and organizational skills
• Excellent oral and written skills
• Demonstrated ability to problem solve and remain calm during a crisis
• Successful clearance of all required criminal history checks…