Summary

Works closely with HHH clinicians and other staff to help consumers access a continuum of care that addresses their health care needs and other critical resources such as long-term care, disability benefits, specialty medical referrals, medication assistance programs, and permanent housing. Provides intensive case management to help client access available resources, transportation coordination, information and referral, crisis intervention, and advocacy. Acts as liaison to other healthcare and homeless services providers in Harris County. Accountable to the Director to Social Services.

The ideal candidate will understand how to work within a multi-disciplinary team environment and coordinate service with identified outside agencies. Will demonstrate strong interpersonal and negotiating skills. Will demonstrate strong analytical skills; strong verbal and written skills. Will demonstrate the ability to use Microsoft computer programs and electronic health records. Will manage time effectively, handle multiple assignments simultaneously, and prioritize projects. Will demonstrate professionalism in appearance and actions.

Job Duties

• Builds and maintains a therapeutic relationship with consumers through engagement and negotiated goal setting. Goals may include housing, substance abuse treatment, mental health treatment, transportation coordination, medical treatment, securing an ID, homeless court, and applying to government funded assistance programs
• Performs assessments of consumer needs and, with consumer, develops a negotiated care plan
• Evaluates and/or revises care plan as indicated with appropriate documentation in progress notes and communicates this to relevant multi-disciplinary team members
• Acts as a liaison and advocates between consumers and a variety of organizations and services, such as medical care, social services agencies, homeless court, and disability benefits
• Develops referral system and cultivates relationships with outside agencies, acts as liaison for patient care referrals
• Maintains all required documentation and required reports on each consumer served to ensure coordinated consumer services and to document program effectiveness
• Maintains agency and consumer confidentiality at all times.
• Provides support services to consumers with physical health, mental health and/or substance abuse problems.
• Builds and maintains a therapeutic relationship with consumers through engagement and negotiated goal setting. Goals may include housing, substance abuse treatment, mental health treatment, transportation coordination, medical treatment, securing an ID, homeless court, and applying to government funded assistance programs
• Performs assessments of consumer needs and, with consumer, develops a negotiated care plan
• Evaluates and/or revises care plan as indicated with appropriate documentation in progress notes and communicates this to relevant multi-disciplinary team members
• Acts as a liaison and advocates between consumers and a variety of organizations and services, such as medical care, social services agencies, homeless court, and disability benefits
• Develops referral system and cultivates relationships with outside agencies, acts as liaison for patient care referrals
• Maintains all required documentation and required reports on each consumer served to ensure coordinated consumer services and to document program effectiveness
• Maintains agency and consumer confidentiality at all times
• Maintains knowledge of organizational policies
• Meets with the Director of Clinical Operations or the Director of Social Services to report any barriers encountered in obtaining consumer’s records
• Uses motivational interviewing trauma informed care, and other appropriate therapies
• Performs other duties as deemed necessary by supervisor
• Performs some travel to offsite destinations for meetings and client coordination.

Minimum Qualifications

• Bachelor's degree in Social Work, Psychology, Human Services or a related field.
• Three years of relevant experience.

Preferred Qualifications

• Clinical assessment experience.
• Familiarity with working with consumers who have experienced homelessness, substance use, incarceration, and mental illness.
• A valid TX driver’s license.