HOME Outreach Care Manager

Job Description

Job Title: HOME Outreach Care Manager

Reports To: Director of Behavioral Health

FLSA Status: Non-Exempt

Status: Full-Time. This position works in the clinic and the community. This position is not a remote position.

OVERVIEW:

This vital member of the Community Access Network’s (CAN) healthcare team is made possible through a partnership with Miriam’s House. This position is a partial grant funded position through The Homeless and Special Needs Housing Program. Therefore, this position adheres to Central VA CoC Written Standards and works to meet CoC-adopted Performance Benchmarks and Program Standards for Street Outreach. The HOME Care Manager will provide outreach and engagement services to unsheltered individuals in the Central VA region. These services are aimed at assisting the most vulnerable homeless individuals to access shelter, housing, and other critical resources to provide safety and stability. Under the supervision of Behavioral Health Director and with close coordination with Miriam’s House Director, the HOME Care Manager will seek to reduce the number of unsheltered persons in the Central VA CoC; provide unsheltered persons with essential services to meet their immediate needs; and connect unsheltered person to the homeless crisis response system and permanent housing options.

ESSENTIAL FUNCTIONS:

1. Street Outreach

2. Care Management and Housing Navigation

3. Community Outreach

4. Administrative Responsibilities

This will include:

A. Working closely with the homeless response system and partners to identify unsheltered persons within the Lynchburg area.

B. Connect with community organizations and locations where unsheltered persons are located such as feeding programs, health centers, and libraries.

C. Make contact and build rapport with unsheltered persons.

D. Make necessary referrals and provide information for unsheltered persons including homeless assistance and community resources.

2. Case Management and Housing Navigation:

This will include:

A. Complete all required Continuum of Care paperwork with each unsheltered person.

B. Verify homeless status of clients through a site visit.

C. Maintain case notes of interactions with clients and gain releases of information to make appropriate referrals.

D. Provide an access point to temporary and permanent housing interventions within the CVCoC’s coordinated entry system.

E. Develop a Housing Attainment Plan with each household to promote attainment and stabilization goals.

F. Provide information, referrals, linkages, and advocacy to assist clients in accessing services and resources.

G. Assist clients with procuring necessary documents and services such as identification cards, birth certificates, social security income, and disability income.

H. Identify appropriate permanent housing options for clients such as subsidized housing, Section 8, and VASH, as well permanent supportive housing, rapid re-housing, affordable and market rate housing, and other housing opportunities.

I. Assist clients with housing applications, complete supportive and subsidized housing paperwork, survey rental market for affordable housing, and advocate for clients with prospective landlords.

3. Community Outreach.

This will include:

A. Liaise with school, police, health providers, churches, community organizations and other groups who might provide services or referrals to the Outreach program.

B. Attend Community Case Review to present unsheltered persons for increased access to housing.

C. Participate in relevant CVCoC committees to provide input on unsheltered persons and to inform policy and service delivery.

D. Participate in relevant community groups and networks to provide information on unsheltered persons and coordinate services for unsheltered populations.

4. Administrative responsibilities.

This will include:

A. Enter client data into HMIS consistent with release of information.

B. Participate in internal staff meetings and weekly case staffing.

C. Assist in the preparation of progress reports to funding bodies as assigned.

D. Participate in ongoing program assessment for overall effectiveness.

E. Complete other appropriate responsibilities as assigned.

SKILLS/QUALIFICATIONS:

Required:

• Bachelor's degree in behavioral science or Humanities field. Qualified Mental Health Professional-Adult
• Or near completion of bachelor's degree in behavioral science or Humanities field
• Or Certified Peer Support Specialist
• a valid VA driver’s license and reliable transportation

Preferred

• At least two years of experience working in a clinical setting with persons diagnosed with mental illness and/or substance use and/or individuals who are homeless.
• Basic understanding of psychopharmacology
• Sensitivity and experience working with people of diverse racial, ethnic, and cultural backgrounds
• Familiarity and comfort working with issues related to sexual health and sexual identity, substance abuse, and/or history of trauma
• Knowledge of Integrated Behavioral Health models
• Understanding and ability to coach others in Harm Reduction, Stages of Change, and Trauma-Informed Care
• Strong interpersonal, written, and oral communication skills; proven ability to communicate with diverse audiences
• Strong administrative skills and proficiency in Microsoft Office Suite (Word, Excel, Outlook) and ability to learn new electronic health record and practice management software.

REQUIRED VALUES:

• Commitment to the vision of CAN that everyone has a medical home providing optimal individual and community wellness. Work collaboratively, respectfully, and effectively with others and encourage open expression of ideas and opinions.
• Practice cultural humility, avoid making assumptions about the knowledge, behaviors, or values of patients.
• Develop and maintain positive supportive working relationships with patients, providers, community organizations, and others.

Job Type: Full-time

Pay: $19.00 - $21.00 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Health insurance
• Paid time off

Ability to Commute:

• Lynchburg, VA 24504 (Required)

Ability to Relocate:

• Lynchburg, VA 24504: Relocate before starting work (Required)

Work Location: In person

Salary : $19 - $21