Outreach MOUD Care Navigator

About the role

The Outreach MOUD Care Navigator plays a crucial role in helping Evergreen Treatment Services (ETS) achieve its mission by providing care coordination, outreach, engagement, and case management services to adults experiencing behavioral health challenges, homelessness, and substance use disorders.

Responsibilities

• Receive warm handoffs from the Harborview-based Navigator and initiate engagement prior to discharge.
• Build rapport with high-risk individuals and conduct outreach in community settings (street, shelter, clinic) to engage and re-engage participants post-discharge.
• Respond to referrals from REACH staff and partners (e.g., Public Health Street Medicine, ETS-TIM, DESC ORCA) for MOUD linkage support.
• Coordinate and support direct transport from Harborview to MOUD providers immediately upon discharge.
• Maintain close follow-up during early engagement.
• Provide focused, short-term case management to address immediate barriers to MOUD engagement, including transportation, housing instability, communication access (phones), insurance, and co-occurring health needs.
• Develop practical care plans to support stabilization beyond the first visit and proactively reengage participants who disengage.
• Deliver harm reduction education and supplies in community settings, including overdose prevention, naloxone distribution, safer use & recovery strategies.
• Support participants in understanding MOUD options and navigating treatment in a low-barrier, patient-centered manner.
• Partner closely with the Harborview-based Navigator to ensure continuity across hospital and community settings.
• Coordinate with MOUD providers, REACH teams, shelters, and partner organizations to align care plans and reduce service gaps.
• Participate in case conferencing and cross-system collaboration to improve linkage and retention outcomes.
• Document outreach, care coordination, and client engagement activities in required systems.
• Identify and elevate systemic barriers impacting MOUD access and retention to support program and system-level change.

Requirements

• High School Diploma or GED required; additional education preferred.
• Academic training in social services, substance use disorder, and mental health treatment desired.
• Lived experience is highly desirable and may substitute for some educational requirements if relevant project management and/or effective team-building experience is demonstrated and reflected in work history.
• Minimum of three years of experience in social work, outreach programs, or a related field.
• Knowledge of the medications used to treat opioid use disorder (e.g. methadone, buprenorphine, etc.) and ability to offer options counseling related to this service adapted to an individual’s stage of change.
• Experience providing services from a harm reduction perspective to individuals experiencing behavioral health challenges is highly desirable.
• Understanding of racial justice and social equity and a commitment to helping create an equitable environment for all ETS clients and patients as well as fellow staff.
• Strong interpersonal skills and verbal/written communication skills.
• Excellent organizational skills and ability to prioritize workload, work independently, and complete tasks timely and efficiently.
• Dependable, able to work under pressure, receptive to change, willingness to learn, cooperative approach to problem solving.
• Flexible team player, with excellent attention to detail.
• Ability to maintain confidentiality and use discretion when handling highly sensitive information.
• Adherence to all confidentiality requirements and guidelines outlined in the 42 CFR, Part 2 federal regulations pertaining to SUD treatment records.
• Ability to set boundaries, resolve conflict and de-escalate issues.
• Computer literate, with basic knowledge of Microsoft Office Suite, as well as a high level of initiative in keeping current with technological change.