Case Manager - Mobile & Street Medicine

Healthright 360•San Francisco, CA

40d

About The Position

The Case Manager on this team will provide intensive, client-centered case management services to support clients in achieving stability, health, and self-sufficiency. This role will provide ongoing support and monitoring progress towards care plan goals for a specific caseload of clients served by this team. The Case Manager I will utilize motivational interviewing, trauma-informed care, and harm-reduction approaches while working with the client to address specific needs such as health benefits, mental health, substance use disorder, physical health, employment, family and children services, Justice-Involved concerns, housing, community resources, outpatient substance use disorder services, and aftercare. This role will take part in Enhanced Care Management (ECM) through SF health plans and the Integrated Care Clinic (ICC), which is HealthRIGHT 360's brick-and-mortar primary care clinic at 1563 Mission Street, San Francisco. While often in collaboration with the rest of the Mobile & Street Medicine clinical team, the Case Manager I will engage with unhoused individuals in their lived environments to provide care management services.

Requirements

High school diploma or equivalent.
A minimum of two years of case management experience.
At least one year of experience working with individuals experiencing homelessness or with vulnerable populations.
Current First Aid and CPR certification.
Valid California driver's license, access to registered and insured transportation, and a clean driving record.

Nice To Haves

Bachelor's degree in social work, nursing, public health, or related field.
Experience working with clients experiencing acute withdrawal from substances.
Experience delivering evidence-based practices.
Experience providing trauma-informed services.
Experience working with individuals experiencing homelessness.
Experience in whole person care or ECM is preferred.
Experience providing counseling and support to individuals with substance use disorders (SUD) is preferred.

Responsibilities

Provide intensive case management to individuals experiencing homelessness in San Francisco, including comprehensive assessments to identify medical, physical, and psychosocial needs.
Develop and implement individualized care plans in collaboration with clients and a multidisciplinary team, monitoring progress toward goals.
Manage a caseload using evidence-based approaches such as motivational interviewing, trauma-informed care, and harm reduction.
Identify and engage eligible clients through various outreach strategies, including in-person contact, phone, text, email, and mail.
Maintain consistent communication with healthcare providers, justice system contacts, and other service partners to ensure coordinated, integrated care.
Coordinate and track referrals and follow-ups for primary care, behavioral health, substance use treatment, housing, and other essential services.
Support client engagement through assistance with medication management, appointment scheduling and reminders, transportation, and accompaniment to key appointments.
Complete intake assessments, monitor treatment progress, and assist with documentation such as releases of information and managed care plan requirements.
Connect clients with benefits and community resources including healthcare, housing, employment, and education.
Collaborate with probation officers, courts, Family and Children Services, and other agencies to support community reintegration and access to recovery programs and support services.
Advocate for clients across systems of care, helping them navigate complex healthcare and social service environments.
Participate in additional case management duties as directed by the Mobile Medicine & Street Medicine leadership team.
Documents care promptly according to charting protocols and clinic policies in the electronic medical record (EMR).
Write clients' progress letters and court reports.
Complete all assigned Peer Reviews (Chart Audits) within a timely matter.
Actively participate in assigned Group Supervision, agency, and team meetings.
Participate in training opportunities and complete assigned training in a timely manner.
Attend and actively participate in assigned case conferences to advocate a collaborative discussion for treatment needs.
Actively participate in agency and team meetings.
Participate in training opportunities.
Complete all assigned training and Relias course assignments in a timely manner.
Travel frequently as part of this field-based position.
Provide client engagement and case management services at locations that are most accessible and comfortable for clients, including on the street, in encampments, shelters, community sites, homes, temporary housing sites, the mobile medical van, residential treatment facilities, and the Integrated Care Center (ICC).
Utilize office space as needed for case management activities, clinical supervision, and to attend required training and meetings.