Care Manager- East New York

Housing Works is a healing community of people living with and affected by HIV/AIDS. Our mission is to end the dual crises of homelessness and AIDS through relentless advocacy, the provision of lifesaving services, and entrepreneurial businesses that sustain our efforts.

The Care Manager has the overall day to day responsibility for the coordination and delivery of Health Home services including: comprehensive case management, care coordination and health promotion, comprehensive transitional care from inpatient to other settings, individual and family support, referral to community and social support services and the use of health information technologies.

* Assess clients’ needs for services and cooperatively develop an integrated care plan and goals with the client/family and other providers. * Maintain documentation and update care plans at specific time intervals or as needed in Housing Works and Health Home electronic medical records system * Work and communicate effectively with interdisciplinary team of providers, including Primary Care Provider, psychiatrist, therapist, substance abuse treatment programs and other providers. Attend Integrated Case Conferences as scheduled. * Work with the client to identify barriers to goal attainment and help resolve those barriers, i.e., keeping scheduled appointments with appropriate service providers, medication regimen for adherence while promoting good health * Conduct field work, to client home and other provider settings, as needed to fulfill plan of care Coordinate transitional care from an inpatient service to other settings as per care plan * Work collaboratively with team members to provide outreach and engagement to hard to reach clients * Provide assistance through advocacy and psycho-education to client and family for entitlements and other community services * Participate in staff meetings, training and supervision * Consistently exhibit Housing Works core values of team work, open book management, advocacy and customer service * Performs other duties as requested

* Bachelor’s Degree plus 2 years related experience preferred. Masters Degree in related field may be substituted for 1 year experience. Associates Degree or related Certificate program plus three years experience may be considered. * Good verbal and written communication skills. * Computer literate and working knowledge of Microsoft Office (Word, Excel). * Good interpersonal skills and ability/interest in working as part of a team. * Knowledge of HIV/AIDS, substance use, homelessness and mental illness, chronic medical conditions. * Knowledge of City, State, and Federal entitlement systems is helpful.