Transitional Housing Case Manager I

Veterans Place of Washington Boulevard•Pittsburgh, PA

1d•Onsite

About The Position

The Case Manager Level 1 is a core member of the Veterans Place Housing Team and is responsible for delivering direct case management services to veterans residing in transitional housing and VA contract bed programs. The CM 1 provides individualized support focused on stabilization, goal achievement, permanent housing placement, and reintegration into the community. The Case Manager 1 serves as a consistent point of contact for veterans navigating barriers related to homelessness, behavioral health, unemployment, substance use, and trauma. This position requires strong engagement skills, detailed documentation practices, and the ability to coordinate across multiple departments and external systems, particularly with the U.S. Department of Veterans Affairs (VA). Under the direction of the Director of Housing and Support Services, the Case Manager 1 works to ensure every veteran receives personalized, timely, and effective care.

Requirements

Bachelor's degree required in Social Work, Psychology, Human Services, or a related field (Master's preferred) or equivalent in experience.
Minimum 1-2 years of experience working in case management, homeless services, behavioral health, or recovery settings
Strong knowledge of veterans' services, trauma-informed care, and housing-first approaches preferred
Excellent documentation and communication skills; BestNotes or EHR experience preferred
Ability to work in a structured, policy-driven environment while meeting veterans where they are
Strong organizational skills and ability to manage a dynamic caseload
Valid driver's license and insurable driving record required
Must pass a pre-employment drug screen and background check
Ability to focus on Recovery Support program details, follow through with timelines, and attend to multiple tasks and interactions.
Ability to retain and recall information regarding clients, policies, procedures, and schedules.
Capable of identifying issues, evaluating solutions, and making appropriate decisions independently or collaboratively.
Ability to comprehend written and verbal information, express thoughts clearly, and communicate effectively with diverse populations (e.g., staff, veterans)
Capacity to manage time effectively, maintain accurate records, coordinate meetings.
Adequate visual acuity (with or without corrective lenses) to read documents, use a computer, and observe participants in meetings or events.
Adequate auditory ability (with or without assistive devices) to understand conversations in person, over the phone, or in virtual meetings.
Clear verbal expression to articulate expectations, deliver feedback, and conduct presentations
Must be able to lift, carry, and move materials weighing up to 50 pounds regularly using proper lifting techniques.
Required to stand or walk for 6 to 8 hours daily on concrete surfaces.
Ability to sit and use computer for extended periods (4+ hours) with breaks.
Job functions include working outdoors in varying weather conditions including heat, cold, and rain.
On-site position based at Veterans Place residential campus
Requires daily veteran interaction and weekly in-person meetings
May involve occasional evening/weekend work (emergency transportation, discharge support, community events)
Expected to demonstrate high standards of professionalism, cultural humility, and integrity
Must remain calm and solution-oriented when working with individuals in crisis or emotional distress

Responsibilities

Carry and manage an active caseload of veterans within the transitional housing and contract bed programs.
Complete comprehensive initial assessments within 72 hours of admission, including psychosocial history, needs, strengths, and barriers.
Develop and maintain Individualized Service Plans (ISPs) for each veteran, ensuring goals are: Specific Measurable Achievable Relevant Time-bound (SMART)
Update ISPs monthly or as circumstances change, including clinical notes to reflect all veteran progress, challenges, and decisions.
Conduct weekly in-person check-ins with all assigned veterans to monitor safety, stability, and progress.
Utilize motivational interviewing and trauma-informed care practices to promote engagement and empowerment.
Initiate discharge planning on day one of a veteran's admission.
Develop structured discharge plans that address: Permanent housing pathway (HUD-VASH, SSVF, independent market housing) Income stability (employment or benefits) Connection to long-term care or community support Mental health and/or substance use continuation plans
Coordinate housing searches, applications, and lease-up processes with veterans nearing discharge.
Provide referrals and linkages to aftercare services to reduce risk of recidivism post-discharge.
Ensure veterans are not discharged without a complete plan, appropriate support, and documentation of their next steps.
Complete and maintain all required documentation in BestNotes in accordance with: VA GPD program requirements Veterans Place internal policies CARF accreditation standards
Enter all case notes within 24 hours of contact and respond promptly to audit feedback from CM Level 2A and the Director of Housing and Support Services.
Ensure timely and accurate reporting of program milestones such as housing placement, employment gains, and community service hours.
Support veterans in accessing and managing benefits including: VA healthcare Social Security Disability (SSDI/SSI) SNAP HUD-VASH
Make appropriate referrals for: Mental health counseling Substance use recovery Primary care and specialty medical services Legal assistance and veteran's advocacy
Assist with housing navigation tasks such as: Preparing housing documentation (IDs, income verification, references) Completing housing applications Connecting with landlords and support programs
Provide veterans with support for appointments, including scheduling, follow-up, and transportation when needed.
Attend and contribute to weekly townhouse meetings within the housing units.
Participate in monthly community meetings, reinforcing program structure, rules, and safety.
Support CM 2B in ensuring veteran participation in group activities and community accountability.
Co-lead or support weekly groups focused on life skills, budgeting, interpersonal communication, and relapse prevention, when appropriate.
Assist in resolving interpersonal conflicts among veterans using de-escalation and mediation techniques.
Attend and actively participate in bi-weekly treatment team meetings, providing updates on: Caseload status Veteran behavioral issues Service plan progress Discharge readiness
Collaborate with: VA GPD and Contract Bed Liaisons to align veteran services and pass approvals Facilities Director for room inspections, maintenance concerns, and behavioral incidents Workforce Development and Veteran Resource Center (VRC) to link veterans with employment and educational services Assistant Case Manager Coordinator for behavioral monitoring and daily support needs
Report veteran crises or incidents to the Director of Housing and Support Services immediately and participate in post-incident debriefs and follow-up planning.