The Flexible Housing Case Manager is responsible for the coordination and delivery of quality direct case management and stabilization services for clients in the Supportive Housing Program. The Health and Housing Case Manager is instrumental in ensuring housing stability for clients with complex medical needs while following standards, practices and specific responsibilities as required by specific funders.
Housing Case Management
- Work collaboratively with Housing Coordinator to assist the clients in obtaining permanent housing and address any barriers. Serve as a bridge to agency services and facilitate community-based referrals in conjunction with care coordinates during the pre-housing placement process.
- Conducts monthly home visits to ensure housing stability, support in development of life skills, to foster emotional support through a strengths-based approach and to ensure compliance with lease.
- Performs crisis prevention and interventions as needed using harm reduction and trauma-informed philosophies.
- Develops Individualized service plan in collaboration with the program participants as required by agency standards and funding sources. Evaluates effectiveness of service plans based upon participants outcomes in the scope of work and adjusts plans as necessary.
- Refers and links participants to appropriate services.
- Assists participants to increase their income by assisting with enrollment in public benefits such as SNAP, SOAR or employment readiness programs.
- Supports participants in developing or enhancing life skills and assists participants in increasing involvement in social life and physical activity;
- Complete all internal and external reporting via client databases and maintain effective documentation and record keeping including incident reports, client case files, and other programmatic needs accurately and in a timely manner as directed by the supervisor.
- Develop, coordinate, and facilitate monthly Tenant’s Clubs with housing case managers as needed.
- Develop and maintain service linkages to support clients/residents and their families, including developing relationships with local service providers.
- Transport clients or arrange for transportation to housing, legal, and medical appointments as needed.
- Provide ongoing life-skills training including problem solving and coping/ skill development to aid in the participants’ process of improving independence and quality of life.
- Refer participants to mental health and other supportive services as needed.
- Establishing a broad based knowledge of community services and communicating appropriate referrals to clients.
- Assure access and continued eligibility to appropriate entitlements in which participants may be eligible.
- Participate in on site and off site trainings and meetings, as needed.
- Work as part of a team to ensure service delivery to all members of Supportive Housing Program.
Health Case Management
- Assists participants in receiving timely and coordinated access to medically appropriate level of health and support services as part of their routine medical regimen.
- Verifies enrollment in medical care or supports participants to engage in medical care by providing information, assisting in finding medical provider or helping participants make appointments;
- Assists participants with the annual insurance enrollment/renewal process.
- Assists participants in securing other public and private programs for which they may be eligible (Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer’s Patient Assistances Program, other state or local health care and supportive services, and insurance plans through the health insurance Marketplace/Exchanges).
- Coordinate medical care plan with participants primary care provider and care coordinators, including, but not limited to, case conference with participants medical provider, attending participants appointment and ensure all participants attend a minimum of two medical appointments pre year;
- Refers and links participants to appropriate services within the system of care that promotes positive health outcomes, treatment adherence, and greater self-sufficiency. Monitors participant’s follow-through with services;
- Assist in connecting participant with accessing services, resources, and financial assistance as necessary to promote and maintain positive health outcomes;
- Assist homeless individuals to overcome system complexities and to provide linkage and/or placement, in conjunction with care coordinators and case managers, to immediate housing placement in shelters, bridge units and other homeless resources.
- Attend external and internal case staffing meeting necessary to coordinate services for the clients in the program.
- Other duties as assigned.
- Works in collaboration with the Cook County Health and Hospital System Care Coordinators and Coordinated Entry to receive referrals for placement in the HUD supportive housing program, attends all partner meetings to provide updates, addresses participant concerns and successes, and troubleshoots issues with peers;
- Attends all mandated trainings;
- Actively participates in agency supervision.
Documentation & Recordkeeping
- Completes case notes & services topics in HMIS within five-business day of interaction;
- Completes annual & six-month assessment and enter in HMIS within five business days of completion;
- Maintains all applicable and required documentation in participants files
- Assist with agency-wide activities as directed
- Protect organization's value and manage risk by keeping information confidential;
- Perform other duties as assigned.
Knowledge, Skills, and Abilities
- Comfortable engaging homeless or formerly homeless populations.
- Knowledge of the factors that cause homelessness.
- Demonstrates experience and ability to interact sensitively and respectfully with persons with severe disabilities (mental health, substance abuse or other disability condition) and homeless difficulties.
- Demonstrates strong skills in interviewing, engagement, assessment, planning and advocacy.
- Demonstrates common sense, good judgment, and ability to work independently.
- Ability to work in an interdisciplinary team approach model, taking individual responsibility and autonomy while also working well in roles leading and serving as part of a team.
- Active listening skills.
- Strong attention to detail and the ability to provide efficient, quality service to both internal and external customers.
- Solid interpersonal skills along with the ability and willingness to respect and value the differences and perceptions of different groups/individuals.
- Adaptability/flexibility skills and ability to follow up with clients in a timely manner.
- Strong written, organizational, communication and presentation skills. Intermediate computer skills.
- Bachelor’s degree in Social Services or related field and 2 or more years’ Supportive Housing Case Management experience. Preference given to candidates with experience applying Homelessness and Supportive Housing concepts and experience applying Harm Reduction and Housing First philosophies
- Valid driver’s license, with safe driving record and valid insurance
- Ability to lift and/or move 50 lbs
- Must have smartphone to utilize Agency communication and collaboration tools
- Must provide proof of COVID-19 vaccination