Case Manager III

LIFELONG MEDICAL CARE•Oakland, CA

1d•$29 - $34•Hybrid

About The Position

The Case Manager III (CM III) is a vital part of the primary care interdisciplinary team, dedicated to serving patients with complex care needs within the Supportive Housing Program in Oakland, CA. This role involves patient outreach, engagement, and psychosocial assessments. The CM III plays a key role in developing patient-centered care plans, leading the implementation of Enhanced Case Management (ECM), and coordinating referrals and service delivery. Services are provided in various settings, including homes, clinics, community sites, hospitals, supportive housing, encampments, and shelters, tailored to the specific needs of populations with multiple, complex health and social service requirements. A significant aspect of this role includes providing comprehensive housing navigation support. This position is represented by SEIU-UHW, with salaries and benefits governed by a collective bargaining agreement (CBA). Employees must maintain good standing within SEIU-UHW as per the CBA.

Requirements

High School diploma or GED
At least three (3) years of progressively responsible work or volunteer experience in a community-based health care or social work setting OR at least one (1) year of experience as a Case Manager II or equivalent position OR registration or certification as a Certified Alcohol and Drug Counselor by one of the two certifying bodies in California.
A Master’s degree in social work and registration as an Associate Social Worker with the California Board of Behavioral Sciences can substitute for the 2 years of experience requirement.
Working knowledge of the local behavioral health service system.
Familiarity with evidence-based practices for behavioral health disorders.
Experience in clinical case management and harm reduction.
Proficient skills using Microsoft Office applications (Word, Excel, Outlook) and ability to work in/manage databases.
Access to reliable transportation with a current license and insurance.

Nice To Haves

Lived experience relative to working with people experiencing homelessness (e.g. formerly homeless, social or behavioral health services consumer, criminal justice system involvement, foster care involvement, close family-member of someone with these experiences).

Responsibilities

Conduct patient outreach via telephone and in person at LifeLong, community, and residential sites for eligible or prioritized patients.
Engage with patients to build relationships and assess strengths and needs using standard tools and review of health/social services records.
Involve patients and caregivers in care plan development, ensuring alignment with patient values and goals.
Provide and facilitate referrals for internal and external resources, assisting with applications, forms, and releases of information.
Manage a patient caseload according to LifeLong standards and program/site requirements.
Utilize data registries and reports for caseload management, program compliance, grant deliverables, and quality care.
Provide health education and training, including harm reduction and disease risk mitigation strategies.
Assist patients in accessing and retaining public benefits, insurance (MediCal, SSI/SSDI, CalFresh, General Assistance), and affordable housing.
Communicate respectfully with patients, care teams, external partners, and social supports.
Maintain knowledge of patients’ medical/behavioral health treatment plans and facilitate service utilization.
Participate in team meetings for care coordination, patient goal support, and barrier reduction.
Provide case management for patients with complex acute or chronic medical or behavioral health conditions.
Offer general housing case management services, including document readiness, problem-solving, and Coordinated Entry System assessments.
Assess patients for cognitive and/or behavioral health needs, providing brief interventions and short-term support.
Co-facilitate patient groups.
Provide intensive case management for the highest acuity patients.
Offer specialized housing navigation services for patients matched through the Coordinated Entry System.
Lead crisis intervention response, de-escalation, and follow-up care.
Document and provide billable services for revenue generation.
Advocate for patients and support their self-advocacy skills.
Maintain current knowledge of community resources and social service supports.
Document patient contacts and services in required data systems (EHR, HMIS) per LifeLong policy.
Promote diversity, equity, inclusion, and belonging.
Represent LifeLong positively in the community and advocate for underserved populations.