Community Support Lead Care Coordinator (Housing)

Pacific Health Group•Imperial, CA

21h•Hybrid

About The Position

Pacific Health Group is hiring a Community Support Lead Care Coordinator for its Medi-Cal Community Supports Program. The role provides person-centered housing care management to members who are unhoused or at risk of homelessness, including people with complex mental health and substance-use needs. The coordinator supports Housing Transition Navigation Services, Housing Tenancy & Sustaining Services, and Housing Deposit assistance, helping members obtain and retain stable housing while connecting them with healthcare and community resources. This is a highly field-based position with a hybrid remote arrangement and occasional required fieldwork across the hiring county and surrounding counties. Duties include outreach by phone and in person; comprehensive intakes and housing assessments; care-plan development; housing-resource applications and documentation; landlord and provider coordination; unit habitability inspections; crisis escalation; and accurate, real-time charting. The role manages a dynamic caseload of approximately 60–70 members and requires independent organization, persistent engagement, and coordination across multiple platforms. The coordinator also represents Pacific Health Group in community outreach, develops relationships with housing and service partners, contributes resources and cross-coverage to the team, and supports new Lead Care Managers during shadowing. Success is measured by housing placement and retention, member engagement and care progression, timely service coordination and documentation, effective caseload management, strong community partnerships, and compliance with program requirements.

Requirements

Strong understanding of the housing system and demonstrated working knowledge of local housing resources, housing navigation, community-based support programs, or transitional housing support workflows such as Medi-Cal, CalAIM, Community Supports, or HUD programs.
Three to five years of experience in case management, social services, or healthcare.
Experience independently managing an active caseload in care coordination, housing navigation, or case management.
Strong understanding of healthcare systems, managed care, and community resources.
Strong communication, empathy, and cultural competence.
Strong organizational and time-management skills.
Proficiency with technology, including case management systems, EHR platforms, and documentation tools.
Ability to document in real time and manage member data accurately while navigating multiple systems and communication platforms.
Ability to travel within the hiring county and surrounding counties.
Valid California Driver’s License and active auto insurance meeting California requirements.
Reliable personal vehicle for daily work use.
Comfort and compassion when working with people facing severe mental health challenges, with strong emotional intelligence and demonstrated de-escalation techniques during crises.

Nice To Haves

Experience with Medi-Cal, CalAIM, and Community Supports programs is preferred.

Responsibilities

Support members experiencing homelessness or at risk of homelessness through Housing Transition Navigation Services.
Coordinate Housing Tenancy & Sustaining Services, including ongoing case management, advocacy, landlord engagement, and connections to healthcare, behavioral health, and community resources.
Assist members with Housing Deposit assistance by gathering and processing required documentation and coordinating landlord allocations.
Conduct telephonic outreach, comprehensive intakes, member assessments, and in-person housing assessments.
Develop and manage individualized housing care plans and coordinate appointments, services, and long-term housing support.
Provide face-to-face case management in shelters, community settings, and residences, including unit habitability inspections and active member outreach as needed.
Manage a caseload of approximately 60–70 members, including outreach, enrollment, monthly touchpoints, care coordination, barrier mitigation, and crisis escalation.
Collaborate with housing authorities, landlords, shelters, property managers, healthcare providers, payers, and community-based organizations to support housing placement and tenancy.
Monitor housing stability and proactively address barriers that could put housing or health outcomes at risk.
Connect members to housing resources and support long-term housing stability.
Represent Pacific Health Group at community outreach events and build referral routes and community partnerships.
Maintain accurate, timely, real-time documentation and track member progress, outcomes, and service delivery in compliance with Medi-Cal, CalAIM, and Community Supports requirements.
Work with interdisciplinary teams, including behavioral health, outreach, and social services, to ensure continuity of care.
Participate in departmental huddles, share housing resources with teammates, provide cross-coverage, and assist with new Lead Care Managers’ shadowing sessions.
Collaborate with leadership during coaching sessions, incorporate feedback, and identify trends and service gaps for program improvement.