Care Coordinator

Care Coordinator

The Care Coordinator is responsible for managing a caseload of Transitional Age Youth (TAY) and ensuring participants are successfully engaged in services, progressing through the program's phased model, and maintaining housing stability. This role prioritizes coordination, accountability, and outcomes by connecting participants to specialized services and monitoring their progress toward education, employment, and permanent housing.

Job Duties:

• Serve as the primary point of contact for participants from intake through program exit
• Complete intakes, enrollments in HMIS/ETO and/or other internal systems, and initial assessments to identify needs and eligibility
• Develop and oversee individualized case plans aligned with the program's phased model
• Connect participants to appropriate services, including Career Services Specialists (CSS), Occupational Therapy (OT), Housing Navigators, Behavioral Health, Medi-Cal, and community resources
• Manage a caseload of 4550 participants
• Monitor participant engagement and progress across all phases, ensuring timely movement from stabilization to housing and intervene when barriers or disengagement occur
• Collaborate with CSS, OT staff, and Housing Navigators to ensure referrals are completed and services are effectively accessed
• Coordinate care across teams to support measurable progress toward education, employment, and housing outcomes
• Maintain responsibility for housing stability, including monitoring program compliance and addressing behavioral concerns using a trauma-informed and progressive approach
• Complete incident reports, documentation, and write-ups as needed
• Work to prevent terminations through early intervention and coordination
• Ensure accurate, timely documentation in HMIS and other systems, including case notes, service connections, and outcome tracking
• Administer phase-based responsibilities, including:
• Phase 1: Engagement & Stabilization
• Complete intake, enrollment, and initial assessment
• Identify immediate needs and service eligibility
• Connect participants to CSS, OT, and behavioral health services
• Establish initial goals and case plan
• Support program compliance
• Phase 2: Active Participation & Skill Building
• Monitor engagement in education, employment, OT services, and/or mental health / substance use
• Track attendance, participation, and progress
• Address barriers to engagement and coordinate interventions
• Support income development and program compliance
• Phase 3: Housing Navigation & Transition
• Refer participants to Housing Navigator
• Support program compliance
• Support housing readiness and documentation
• Coordinate with housing staff to ensure smooth transition
• Prepare participant for successful program exit

Qualifications:

• Bachelor's degree (preferred) in social work, human services, psychology or a related field and equivalent work experience of up to one year required.
• Experience working with transitional age youth or individuals experiencing homelessness
• Excellent computer skills
• Proficiency with Google Workspace and electronic case management systems
• Strong interpersonal and communication skills, both written and verbal
• Demonstrated knowledge of trauma-informed care, harm-reduction models, advocacy and support techniques for victims and survivors of violence, individuals with mental illness and/or substance abuse issues.
• Ability to work independently, manage time effectively, and prioritize tasks
• Cultural sensitivity and experience working with diverse populations
• Ability to advocate effectively and maintain professional boundaries

Preferred Qualifications:

• Bilingual (Spanish preferred)
• Two (2) or more years of experience in employment navigation, homeless services, or case management
• Knowledge of San Diego County employment and community resources
• Experience supporting individuals with serious mental illness, substance use disorders, chronic medical conditions, or justice system involvement
• Experience assisting participants with Medi-Cal, CalFresh, CalWORKs, SSI/SSDI, or other public benefits
• Training in Motivational Interviewing, Trauma-Informed Care, Harm Reduction, Crisis Intervention, De-Escalation, Suicide Prevention, or Domestic Violence
• Experience using electronic case management systems such as Efforts to Outcomes (ETO), HMIS, or related databases

Benefits:

• Medical
• Dental
• Vision
• Life
• Ancillary offerings
• 401k

It is the policy of Urban Street Angels, Inc. to ensure equal employment, contractor and volunteer opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, age, disability, marital status, citizenship, national origin, genetic information, or any other characteristic.