Retention Adherence Specialist - ALLY Care Center

Westchester Medical Center Advanced Physician Services, P.C. 
Human Resources 
Job Description

To apply

Email Alexis Sanchez, Practice Manager for ALLY Care Center
[email protected]

Title: Retention Adherence Specialist 

Job Code: A1056

Reports To: Practice Supervisor 

Department: Outpatient – Ally Care Center 


Primary Responsibilites

  • Identifies clients appropriate for the Retention and Adherence Program (RAP) based on eligibility criteria, including but not limited to the following: 
    • BIPOC, LQBTQIAA+, or other communities experiencing disparate HIV outcomes o Newly diagnosed with HIV 
    • Out-of-care or not regularly engaged in care 
    • Not virally suppressed (determined by most recent viral load test within 6 months prior  to enrollment) 
    • Not enrolled in another case management program at the agency. 
  • Enrolls eligible clients in RAP program, creates a care plan individualized to the client’s needs,  and updates this care plan every 6 months. Similarly, performs an initial assessment of client  and re-assesses client every 6 months.  
  • Assists patients by acting as an advocate and navigator, promoting clean communication among  care team and treating clinicians. 
  • Assists patients with understanding their medical diagnoses, treatment options and achieving  best outcomes. 
  • Serves to directly communicate emergent information to clinicians and discuss/address needed  lifestyle modifications 
  • Assesses, identifies and addresses social determinants of health for people living with HIV Assists with scheduling and obtaining authorizations for diagnostic testing, services, medications  and transportation. 
  • Coordinate continuity of patient care when acuity level changes including the process of hospital  admission and discharge, ER visits, home referral services and therapy. 
  • Participates as active team member for data collection, health outcomes reporting, clinical  audits, and programmatic evaluation related to the RAP program. 
  • Manages high risk patient care, including management of patient with multiple co-morbidities  or high risk readmission to a hospital setting.
  • Evaluates clinical care, utilization of resources, and development of new clinical tools, forms and procedures. 
  • Participates in identifying, managing and evaluating a Quality Improvement project on an annual basis 



  • Experience with electronic medical records. 
  • 2-5 years’ experience in a medical office or clinical setting 
  • Medical, Medical Record, Patient Advisory, Social Worker or science background preferred. Experience in medical case management preferred.  


  • Bachelor’s Degree or higher

License, Certification and Registration: N/A 

Other Requirements

  • Team player that can follow a system and protocol to achieve a common goal. Highly organized and well-developed oral and written communication skills Demonstrates sound judgment, decision-making and problem solving skills 
  • Able to maintain confidentiality in accordance with practice, State and Federal regulations Ability to communicate/outreach to other community health care organizations and personnel.

Contributing Organizations