Lead Case Manager - CS - Full-time

Program Overview:   Community supports provides community based, high-touch case management services to assist individuals address their barriers, maintain and sustain permanent housing.

Case management services assist in achieving and maintaining stability as well as self-improvement and self-sufficiency.

 

Essential Duties and Responsibilities:

 

• Provide individualized support by helping each client learn how to address their barriers, maintain and sustain permanent housing
• Provide initial and ongoing client assessments
• Collaborate with community housing agencies to build partnerships with supporting clients transitions to available housing options
• Support clients experiencing homelessness by engaging harder to reach clients about housing opportunities
• Tenant screening and housing assessment, include managing HMIS data entry and use of VI-SPDAT assessments
• Individualized housing support plan development including breaking down barriers in obtaining/sustaining housing
• Support the client with housing applications, programs and other housing services
• Assist with housing search/application completion
• Coordinate with landlords including setting up viewing appointments, lease completion, and any other necessary efforts
• Securing housing resources for subsided rent and housing expenses
• Ensuring living environment is safe and ready for move-in
• Assistance with arranging for and supporting details of the move
• Work with health plans on housing deposits and other services potentially offered to the client
• Support patient with referrals and other supports for move-in
• Provide crisis intervention, referrals, and collaborative consult with any service providers working with client. 
• Maintain up-to-date, accurate written case files for each client, including case notes, case plans, quarterly assessments and other program reports and assessments, as well as other record keeping as required by the agency or program.
• Attend staff huddles and program meetings.
• Serve as a role model to guiding clients and facilitating appropriate behavior regarding daily living skills, self-care, personal interaction, social relationships and constructive time management.
• Other duties as assigned by the Program Manager.

 

Client Outreach

• Contact referrals by phone, or in the place where they can be found, including the street, a health clinic or their home.
• Document all contacts in case note.

 

Intake and Engagement

• Complete all intake paperwork including releases and consent
• Complete Arizona Self-Sufficiency Matrix and Housing assessments.
• Contact all other service providers and social network to introduce LSS services.
• Set up weekly meetings with the client.
• Complete an individualized Case Plan, with the client, within the first four weeks of program.

Milieu Management

• Keep work area uncluttered and organized.
• Facilitate a calm work space and client meeting space.
• Be welcoming and engaged with every client that comes into the office.
• Ensure that your clients know when you are available for drop-in appointments.
• Identify potential crisis situations, and avert the crisis if possible.
• Keep office doors unlocked during business hours, turn on lights, open blinds, create a welcoming environment.

Whole Person Care Management

• Assist client in identifying and building natural supports using a family finding or permanency model.
• Assist clients in accessing resources to address each element of the care plan.
• Provide ongoing assessment of client needs, and adjust the care plan as circumstances change.
• Assist clients in obtaining all benefits for which they are eligible.
• Assist in the development of IADLs
• Assist with obtaining child care, enrollment in school, and parenting.
• Assist with Health Promotion.
• Facilitate groups and/or assign on-line learning modules to address the social determinants of health.
• Provide transportation to appointments and accompaniment to suppor the appointment.
• Provide referrals to services to address specific needs such as mental health and AOD treatment services.

 

System Navigation

• Coordinate all services with the referral source, PCP, service providers, and social Support Network.
• Manage transitions into and out of institutions, including hospitals, incarceration, long-term care.
• Identify and refer to services identified on the case plan.

 

Discharge Planning

• Discharge planning begins at the time of entry to the program.  Each client is assisted in envisioning his or her place to go when the program ends.
• No client is discharged to homelessness.  Assist the client in finding alternate housing if they are asked to leave the apartment LSS procured for them.

Paperwork

• Complete weekly care notes.
• Complete quarterly Arizona Self-Sufficiency Matrix.
• Complete HMIS data within 24 hours of entrance, exit, new household member, to enable timely data entry.
• Complete status updates for HMIS as status changes.
• Complete re-assessments withing 72 hours of due date.
• Additional paperwork requirements many vary depending on the needs of each program

Safety

• Identify and report safety hazards to your supervisor.
• Report any work place accidents to your supervisor immediately.
• Update your client list on the server as the case load changes.

 

 

PHYSICAL DEMANDS:

 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential function of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  While performing the duties of this job, the employee frequently is required to use hands to hold objects, writing instruments, or files; and talk and hear. The employee is frequently required to stand, walk, sit, and reach with hands and arms, to use a computer and smell. The employee must be able to climb stairs. The employee must occasionally lift/or move up to 10 pounds.  Specific vision abilities required by this job include ability to read, close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. This position requires the ability to see, review and share the organizations secure electronic and physical files with other program staff; the incumbent will also have access to the organization’s and other highly confidential information.  Because of this, the employee must have the ability to perform the job at the location of the assigned program or field office(s).

 

The employee frequently will be required to travel to locations within the regional areas of LSS. The employee may on occasion transport clients and help the client (physically and emotionally) navigate government, education, health care and other social service systems. This may require standing in lines, walking up and down stairs  and driving and transporting clients to multiple destinations on any given day. and will conduct care management visits within client’s homes as required.