BHBH Care Coordinator

Pala Band of Mission Indians•Pala, CA

68d

About The Position

The BHBH Care Coordinator provides intensive case management and housing-focused care coordination for individuals and families currently experiencing or at high risk of homelessness. The coordinator plays a key role in connecting clients to stable housing, supportive services, and long-term wellness through a culturally responsive, trauma-informed approach. The position is embedded within a tribal wraparound team and collaborates with Indian Health Services, Behavioral Health, Courts, Parole/Probation, Child Welfare, and other tribal and community-based agencies to promote housing stability, self-sufficiency, and access to essential services.

Requirements

Knowledge of housing-first and trauma-informed care models, especially in serving individuals and families experiencing or at risk of homelessness.
Familiarity with local housing systems, public benefits, and supportive services.
Strong interpersonal and communication skills to engage with clients, community partners, and landlords.
Ability to work independently with strong follow-through, while contributing to a collaborative team environment.
Ability to maintain accurate documentation, case notes, and timely reporting.
Cultural sensitivity and respect for Native communities; support for tribal values and philosophies.
Basic computer skills for data entry, communication, and use of case management systems.
Must maintain confidentiality and follow ethical guidelines at all times.
Bachelor's or Master's Degree in Social Work, Human Services, Sociology, Criminal Justice, or a related field preferred.
In lieu of a degree, four (4) years of relevant experience in housing navigation, case management, or supportive services may be considered
Minimum of one (1) year of relevant experience in housing navigation, case management, or supportive services.
Demonstrated commitment to equity, social justice, and trauma-informed care.
Must maintain strict confidentiality regarding all tribal and client matters.
All employees are expected to follow the Tribal Employee Handbook of the Pala Band of Mission Indians and must adhere to any additional applicable addendums.

Nice To Haves

Previous experience working with Native American communities or vulnerable populations preferred.
Experience working in or alongside tribal communities is highly preferred.

Responsibilities

Maintain a caseload of 12-15 clients, ensuring at least 14 hours of monthly service contact per client, including weekly face-to-face visits.
Conduct thorough intakes within two (2) weeks of referral, identify immediate needs, and begin developing an individualized care plan.
Within 30 days, complete a Plan of Care (POC) and 24-hour Crisis Plan based on client strengths, cultural values, and housing needs.
Collaborate with housing providers, landlords, and agencies to secure and maintain permanent housing placements.
Assist clients in completing housing applications, gathering documentation, and navigating housing authority or tribal housing processes.
Provide tenancy support services, including budgeting, life skills, communication with landlords, and eviction prevention strategies.
Coordinate transportation for appointments and emergency services as needed.
Facilitate access to supportive services, including mental health, substance use treatment, benefits enrollment, and vocational programs.
Monitor service delivery and act as liaison between the client, family, and team to ensure quality and consistency.
Maintain up-to-date, strength-based client records and complete all documentation in a timely manner.
Attend and participate in tribal and county housing case conferencing, team meetings, and interagency collaborations.
Conduct home visits and field-based outreach to support client engagement and housing retention.
Identify and advocate for culturally responsive resources that reflect the needs of Native families and individuals.
Assist with community education and outreach related to housing stability and homelessness prevention.
Support the development and implementation of housing-related programs and policies within the Tribe.
Participate in required training, staff development, and reflective supervision.
Other duties as assigned.
Analyze complex problems and develop culturally appropriate, solution-focused plans.
Manage detailed records, data collection, and client communications effectively.
Interpret housing regulations and funding requirements to support client eligibility and program compliance.
Provide input into program design and continuous improvement based on client outcomes.