Licensed Clinical Social Worker- Behavioral Health & Healthcare Navigation
About The Position
Saint James Health, a Federally Qualified Health Center (FQHC) serving Newark and surrounding communities, is partnering with Bridges Outreach, Inc. to embed a Licensed Clinical Social Worker (LCSW) within the Bridges Outreach Halsey Street Drop-In Center in Newark, NJ. This position represents an innovative integration of behavioral health services within a low-barrier homeless services setting, designed to meet individuals experiencing homelessness where they are and connect them to the full spectrum of primary care, behavioral health, and social services available through Saint James Health and community partners. The LCSW will be co-located at the Bridges Halsey Street Drop-In Center and will serve as a primary point of contact for behavioral health assessment, crisis support, and healthcare navigation for guests of the center. The position is employed and clinically supervised by Saint James Health, while working in close collaboration with Bridges Outreach program leadership
Requirements
- Master's Degree in Social Work (MSW) from an accredited program
- Licensed Clinical Social Worker (LCSW) in the State of New Jersey
- Experience working with behavioral health, homelessness, or vulnerable populations
- Knowledge of trauma-informed care and harm reduction approaches
- Strong care coordination and case management skills
Responsibilities
- Conduct behavioral health screenings and assessments for drop-in center guests, including depression, anxiety, trauma, substance use disorders, and serious mental illness.
- Provide brief individual counseling, supportive interventions, and crisis stabilization using trauma-informed, evidence-based approaches.
- Develop and maintain individualized behavioral health care plans in coordination with Saint James Health primary care providers.
- Facilitate warm handoffs and coordinated referrals to Saint James Health behavioral health services, psychiatric providers, and community treatment programs.
- Participate in care coordination meetings and case consultations with Saint James Health clinical teams.
- Assist guests with enrollment in NJ FamilyCare, Medicaid, and other health coverage programs.
- Connect guests to Saint James Health primary care, dental, behavioral health, vision, and specialty services, supporting appointment scheduling and follow-up.
- Assist with medication access and prescription assistance, including pharmacy program connections.
- Provide education on preventive care, chronic disease management, and harm reduction strategies.
- Coordinate with hospital discharge planners, emergency departments, and community providers to reduce care fragmentation for high-utilizing patients.
- Maintain accurate and timely clinical documentation in Saint James Health's electronic health record (EHR) in accordance with FQHC standards.
- Document relevant encounters and referrals in Bridges Outreach's HMIS system as required for program compliance.
- Participate in case conferencing, coordinated entry activities, and team meetings relevant to the individuals served.
- Assist with data collection and reporting supporting grant requirements and program evaluation.
- Serve as a liaison between Saint James Health and Bridges Outreach to ensure continuity of care.
- Build trusted relationships with drop-in center guests using a Housing First and harm reduction approach.
- Maintain knowledge of community resources across Essex County and facilitate appropriate referrals.
- Participate in community coordination meetings and collaborative initiatives as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
