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Job Req ID:  102696

Facilitator/Counselor, Bartlett Substance Recovery Service

We are seeking a Facilitator/Counselor, Bartlett Substance Recovery Service to join our extraordinary and unique team providing care to people with substance use disorders  in the John G Bartlett infectious diseases (ID) outpatient clinic: The Bartlett Restorative Recovery Support Service. We seek someone who is motivated, experienced with, and invested in the health and well-being of people who use drugs and who have HIV, viral hepatitis C, or other infections. Many of our patients also live with mental health disorders (MHD). We work using a collaborative approach and are mission-driven to support our patients by outreach, linkage, medications, and retention in care in our multi-specialty academic practice.

Based on our East Baltimore Campus, RESTOREative Recovery Support Services includes peer-facilitated support and low-threshold access to medications to treat SUDs such as buprenorphine for OUD and medications for AUD. Our service also provides individual counseling and group therapy to patients in our clinic. Under the direct supervision of the Program Director, in the role of a Peer Coach or Substance Use Counselor and on-the-ground Program Facilitator, this position will ensure fidelity to protocols and assist with program development in efforts to maintain and improve access to substance use disorder treatment for people living with/on the continuum of HIV and/or viral hepatitis. This person will facilitate standardized interventions in keeping with weekly Treatment Team meetings and standard Treatment Plans. They will support clinic staff in creating a stigma-free, patient-centered and treatment-focused culture and help reduce process and information related barriers to care provision and serve as a real-time resource to clinicians seeking to treat their patients for SUDs.

*The person filling this position will be expected to satisfactorily complete courses and/or trainings in the area of SUD care and other topics as requested by the Program Director.

Specific Duties & Responsibilities

40% Program Facilitation

  • Oversee the administrative and implementation of the RESTOREative program protocol.
  • Serve as the point of contact for the RESTOREative program in the Bartlett Clinic, serving as the on-site lead for all questions from clinic staff and patients.
  • Serve as the liaise between the patients and the Bartlett clinic RNs, APPs, MDs and staff in providing SUD care by maintaining a visible daily clinic presence and having necessary resources available as needed.
  • for the complex RESTOREative program.
  • Check clinic schedule ahead of time to see if any of our patients are coming to clinic. Greet them, engage in RESTOREative, check treatment plan for needs and communicate with clinicians and/or staff as needed to coordinate care.
  • Manage Tracker updates, send status and Treatment Plan updates in Epic to Bartlett providers (referral, engaged, change in treatment plan), RN, CM (team).
  • Manage “Contact Trackers” for brevity, completeness and fidelity to patient Treatment Plans, Goals and Steps, patient response to treatment; ensure that referrals tracked, all information on patients are up-to-date, document notes on patient appointments and conversations.
  • Support clinic in providing a stigma-free, patient-centered and treatment-focused culture by 1) being available to address SUD-related concerns as they arise during the day and 2) coordinating scheduled trainings.
  • Serve as the lead in the weekly discussions speak to status of each patient.
  • Participate in development of manuals, training materials etc to support the program goals.
  • Conduct training sessions for junior staff members as well as other staff in the clinic that interact with the RESTOREative program staff.
  • Oversee Fidelity to data collection and tracking relevant to Peer Navigator assignments and interventions.
  • Extend technical support to Peer Navigators in utilizing software and electronic communications systems.
  • Monitor and assist with Peer Navigator documentation in the EMR.
  • Facilitate improvements in EMR documentation options by working with clinical informatics as requested.
  • Maintain up to date understanding of available SUD treatment options in the community.
  • Provide technical assistance to Peer Coaches, e.g. with Epic, Outlook, MS Excel, Redcap, etc.
  • Track due date of prescriptions and route them to the correct provider for signature in Epic ; including: dose, frequency of prescription depending on most updated Treatment Team plan, toxicology results prior to sending a prescription for refill, notify RESTORative supervisor if tox screen results are unexpected.
  • Communication with Bartlett pharmacists and pharmacy assistants; place a 'HOLD' on a prescription when needed, seek pharmacist help as required.
  • Enter all new referrals to Patient Tracker.
  • Work closely with and regularly report to the Program Director.
  • Generate Reports relevant to Bartlett RESTOREative Recovery Support Services as requested.

60%: Direct provision of Recovery Support Services as a Peer Coach or Substance Use Counselor in Collaborative Care Management intervention in Bartlett

  • Under direct supervision of the prescribing clinician, teaches patients how to safely and effectively start taking buprenorphine (also known as initiation or induction).
  • Support patients with HIV and or HCV who have SUD in their recovery goals by providing Recovery Support Services.
  • Maintain own caseload of approximately 30 active patients with SUDs across all Stages of Change (60% of a full caseload).
  • Actively prepare for and participate in routine scheduled meetings: with Consulting Psychiatrist, Assigned Patients, All-Peer Coach meetings.
  • Documents Treatment Plans in the Electronic Medical Record as directed.
  • Communicate directly and succinctly with each patient’s Bartlett clinician on matters related to SUD Treatment Team plans and updates.
  • Participate in trainings in Evidence-Based skills and interventions, treatment and medication options for patients living with HIV, HCV, MHD, SUD.
  • Provide patient-centered care in the model of Collaborative Care Management and a Harm Reduction approach.

Examples of Peer Coach/Substance Use Counselor skills and tasks include but are not limited to

  • Meet with patients at designated intervals to provide Motivational Interviewing and coaching to achieve each patient’s desired goals related to substance/alcohol use.
  • Maintain real-time awareness of patient toxicology results. Share results with patients and the team and use them as a tool in Motivational Interviewing.
  • Effective engagement of patients, support strong alliance between patient and providers, and between Collaborative Care Team members.
  • Provision of evidence-based, algorithm-driven interventions.
  • Clinic appointment reminders and support to all active patients.
  • Assist patients to connect to higher level of care/warm handoff when necessary.
  • Guide patients to utilize appropriate Bartlett and community resources such as: MyChart, scheduling, partnering with RN/CM/pharmacy/peer teams.
  • Communicate patient status and response to treatment at weekly meetings in a succinct manner.
  • Carry work phone and respond to calls and text messages from patients and clinic staff/providers in real time.
  • Meet referred patients in person at the time of referral.
  • Track own patient contacts for reporting purposes.
  • Maintain respect for persons and assume good intentions.
  • Maintain professional boundaries and understand own limits.
  • Seek support regularly, and openly receive supervisor feedback.
  • Maintain up to date basic understanding of care for those with SUD, HIV, HCV and MHD.
  • Immediately communicate urgent psychiatric or medical concerns to clinical supervisor and available Bartlett clinician.
  • Follow Treatment Team decisions and guidance.
  • Participation in ongoing trainings and competency evaluations for barrier and facilitator identification; Creation of achievable, measurable, time-bound Goals and Steps; Motivational Interviewing; Reflective Listening; Self-care; Fundamentals of HIV, HCV, MHD, SUD care and treatment.
  • Basic familiarity with medications used to treat HIV, HCV, MHD and SUD.
  • Support for medication treatment compliance and tracking progress with dose adjustments of medications used to treat SUDs.
  • Safety protocols (suicidal and/or homicidal).
  • Crisis Management, effective de-escalation techniques.
  • Visit engaged or newly referred patients who present to our hospital or Emergency Department.

Tracking of Patient Treatment, includes but is not limited to

  • Use of a Registry to track care plans and patient progress, reach out to patients identified in Registry as needing help, having fallen through the cracks or who require intensification of treatment.
  • Support the Team in evaluating caseload and severity of symptoms.

Collaborative Measurement Based Treatment To Target

  • Use a Stepped Care Approach to change care when symptoms are not improving or if patients are not achieving treatment goals: refer out to specialty care to intensify MDH or SUD treatment when needed.
  • Participate with Collaborative Care Team in evaluating symptoms, creation of a patient-centered treatment plan, patient progress toward clinical goals, adjust treatment to achieve treatment targets.

Ongoing Quality Assurance and Improvement

  • Understanding of Patient and Program-level goals.
  • Maintenance of tracking tools.

Special Knowledge, Skills, and Abilities

  • Demonstrate general knowledge of HIV prevention, HIV treatment, HCV, Substance Use Disorders, Mental Health Disorders.
  • Commitment to striving for culturally congruent care for medically vulnerable populations including but not limited to: Black and Indigenous persons, LGBTQ+ persons, people experiencing current and or generational poverty and/or trauma.
  • Able to positively contribute to a diverse workplace.
  • Strong organizational skills with attention to detail and follow through.
  • Facility with Microsoft software (e.g. Excel, Outlook, Teams), general computer and communications skills including telecommunications (e.g. Zoom meetings)
  • Knowledge of or capacity to quickly gain facility with EPIC, the JH EMR; Redcap and other software programs as needed.
  • Capacity to demonstrate patience, especially in the case of lack of or slow patient progress. Ability to hold patients and coworkers in positive regard.
  • Understanding of principles of Harm Reduction, Stages of Change, and Medications (like buprenorphine) to support wellness and recovery.
  • Lived experience with HIV, substance use, or mental health disorders not essential but highly helpful and welcome.
  • Individual not required to be in recovery from substance use her/himself, but must be able to communicate empathy through lived experience.
  • Flexibility with work schedule days/hours needed.

Minimum Qualifications
  • Bachelor’s Degree in social work, psychology or other appropriate field required.
  • Requires a minimum of three years of related experience in a healthcare or public welfare setting with knowledge of HIV, substance use and mental health disorders required.
  • Additional education may substitute for some experience, to the extent permitted by the JHU equivalency formula.
  • Experience with responsibility for Quality Assurance.


  • Flexibility with evolving research and/or clinical protocols.
  • Ability to shift between in-person and remote work as needed.
  • COVID-19 and influenza vaccination as required by Johns Hopkins.
  • Consistent adherence to COVID-19 safety requirements.

Classified Title: Substance Abuse Counseling Supervisor 
Working Title: ​​​​​​​Facilitator/Counselor, Bartlett Substance Recovery Service   
Role/Level/Range: ACRP/03/MB  
Starting Salary Range: $40,100-$55,140 Annually (Commensurate with experience) 
Employee group: Full Time 
Schedule: M-F; 8:30- 5:00 
Exempt Status: Exempt 
Location: ​​​​​​​School of Medicine Campus 
Department name: ​​​​​​​SOM DOM Infectious Disease  
Personnel area: School of Medicine 


Please refer to the job description above to see which forms of equivalency are permitted for this position. If permitted, equivalencies will follow these guidelines:

*JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.

**Applicants who do not meet the posted requirements but are completing their final academic semester/quarter will be considered eligible for employment and may be asked to provide additional information confirming their academic completion date.

The successful candidate(s) for this position will be subject to a pre-employment background check.


The Johns Hopkins University values diversity, equity and inclusion and advances these through our key strategic framework, the JHU Roadmap on Diversity and Inclusion.


Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.


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