Community Supports Lead Care Coordinator (Housing)

Pacific Health Group•San Diego, CA

4d•Hybrid

About The Position

Pacific Health Group is hiring a Community Supports Lead Care Coordinator to help Medi-Cal members experiencing homelessness or housing instability access and retain permanent housing. The role supports CalAIM Community Supports programs, including Housing Transition Navigation Services, Housing Tenancy & Sustaining Services, and Housing Deposit assistance. The coordinator provides person-centered care management and coordinates housing support with healthcare and community-based services. This is a highly field-based position with a hybrid work arrangement for California remote work and occasional fieldwork. The coordinator conducts telephonic outreach, comprehensive intakes, in-person assessments and case management, unit habitability inspections, and member outreach in shelters, community settings, and residences. The role manages a caseload of approximately 60–70 members and coordinates housing applications, required documentation, deposit assistance, and landlord allocations. The position also builds relationships with housing providers, landlords, shelters, healthcare providers, and community organizations; participates in outreach; supports team collaboration and new Lead Care Manager shadowing; and maintains timely, accurate documentation in compliance with Medi-Cal, CalAIM, and Community Supports requirements. Success includes housing placements and retention, member engagement and progress, effective caseload management, quality documentation, community partnerships, and regulatory compliance.

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.
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.
Excellent 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, manage member data accurately, and navigate 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.

Nice To Haves

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

Responsibilities

Support members experiencing homelessness or at risk of homelessness with 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 coordinating required documentation and facilitating access to deposit support.
Conduct telephonic outreach, comprehensive intakes, member assessments, in-person housing assessments, unit habitability inspections, and face-to-face case management.
Manage a caseload of approximately 60–70 members, including outreach, care plan development, monthly touchpoints, crisis escalation, and ongoing coordination.
Coordinate housing applications and resources, process Housing Deposit Services packages, gather required documents, and coordinate landlord allocations.
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 may put housing or health outcomes at risk.
Develop individualized housing care plans and coordinate appointments, services, and long-term housing support systems.
Build trusting relationships with members and families and advocate for timely care, services, and equitable access to resources.
Represent Pacific Health Group at community outreach events and initiatives, build referral routes, and identify opportunities to improve access to services.
Connect members to housing and community resources, strengthen community partnerships, and identify resource gaps for escalation.
Maintain accurate, timely, real-time documentation of member interactions and comply with Medi-Cal, CalAIM, and Community Supports requirements.
Track member progress, outcomes, and service delivery.
Participate in departmental huddles, share housing resources with the team, provide peer cross-coverage, and assist with new Lead Care Manager shadowing sessions.
Collaborate with leadership during one-on-one coaching sessions and apply feedback to improve workflows.
Identify trends and service gaps and support continuous improvement.