Position Summary:

The Clinical Programs Specialist II (Respiratory Health) serves as an experienced direct care, navigation, and outreach lead within Roots’ Clinical Programs department. Supporting the Respiratory Health Coordinator and Clinical Programs leadership, this role blends clinical program support, patient outreach, care coordination, and health education focused on high-priority respiratory conditions, including asthma, COVID-19, and infectious respiratory diseases.

As a Level II specialist, this position supports a patient panel and leads field-based outreach initiatives targeted at eliminating health disparities in underserved and low-income communities.

Essential Functions:

Direct Care Coordination & Patient Navigation

• Serve as a direct liaison between patients and Roots' Respiratory Health programs, facilitating seamless recruitment, enrollment, intake, and longitudinal care retention.
• Support and track client panel lists, using prioritization skills to schedule and confirm program initiation, specialist referrals, and routine follow-up visits.
• Conduct patient intakes and comprehensive assessments (both in-person and via phone), connecting patients to Patient Services for public benefit enrollment (e.g., Medi-Cal, CalFresh, CalWORKS) and basic needs support.
• Assist patients in understanding disease management concepts and guidelines for respiratory care, including asthma control, COVID-19 management, infection control, and respiratory health maintenance.
• Partner closely with internal navigation teams, medical providers, and clinic staff to ensure an uninterrupted continuum of care and share patient progress updates.

Outreach, In-Reach, & Community Engagement

• Conduct targeted phone outreach and clinic "in-reach" to existing patients to build awareness and engagement in Respiratory Health programs.
• Lead field and street-based outreach to extend critical respiratory health resources directly into the community and engage hard-to-reach populations, including individuals living in encampments, shelters, or temporary housing.
• Support the Respiratory Health Coordinator as an instrumental lead during weekend community outreach events, managing on-site logistics, health screenings, and respiratory health education.
• Build and maintain collaborative partnerships with local Emergency Departments, Community-Based Organizations, and local health initiatives to streamline external patient referrals for respiratory care.

Documentation, Data & Program Support

• Maintain up-to-date, highly accurate records of all patient encounters, referrals, and outreach activities across Electronic Health Record systems and specialized tracking databases.
• Ensure strict adherence to HIPAA compliance and patient privacy standards across all interactions and data entries.
• Assist the Respiratory Health Coordinator and program leadership in tracking program and contract deliverables tied to respiratory health grants (i.e., Asthma and COVID), identifying operational bottlenecks or data collection gaps.
• Meet regularly with Program Coordinators and Managers for case reviews, workflow planning, and program strategy development.

Education & Certification Requirements

• Education: High School Diploma or GED required. Associate or Bachelor’s degree in Public Health, Social Work, or a related field preferred.
• Certification: Completion of an accredited Community Health Worker certification program (or willingness to complete within 6 months of hire).
• Lived Experience: Lived experience within or a strong connection to the communities served by Roots Community Health Center.

Preferred Qualifications & Work Experience

• Minimum 2 years of experience in community health, social services, patient navigation, or public health programs (preferably within a non-profit organization or community clinic).
• Experience working with high-priority clinical conditions, specifically respiratory illnesses (e.g., asthma, COVID-19, infectious lung diseases) or chronic disease management.
• Demonstrated background in conducting community outreach and collaborating with multidisciplinary clinical teams.

Core Competencies:

• Non-Judgmental Advocacy: Ability to discuss health conditions and care management empathetically, respectfully, and without bias or stigma.
• Cross-Cultural Competency: Strong ability to connect respectfully with diverse populations, particularly low-income individuals, unsheltered communities, and communities of African/African ancestry descent.
• Technical Proficiency: Experience navigating Electronic Medical Record (EMR) systems, client tracking spreadsheets, and Google-Suite/Microsoft Office tools (Word, Excel, Outlook).
• Organizational Skills: Excellent time management skills with the ability to balance client case management, panel prioritization, and event planning.
• Flexibility: Willingness to work a flexible schedule, including occasional evenings and weekends for outreach activities.
• Driver’s License: Valid California Driver’s License with a safe driving record (or ability to obtain).

Physical Demands & Working Conditions

• Frequent standing, walking, stair climbing, bending, stooping, and lifting up to 25 lbs.
• Gross and fine manual dexterity to operate standard office equipment and keyboards.
• Ability to work both indoors within a clinic environment and outdoors during street-based outreach or community events.