Community Care Coordinator

Position Title:

Community Care Coordinator

Reports to:

Director of Case Management Fair Labor Standards Act Status:

Non-Exempt Employment Status:

Full-Time Date Revised:

July 29, 2026 Organization Overview: Sound Community Services, Inc. is a private, not-for-profit organization dedicated to educating, assisting, and supporting individuals with persistent mental illness and substance use disorders. We work tirelessly to create a culture and environment in which recovery and wellness are possible. Position Overview: The Community Care Coordinator provides supportive housing services in accordance with the Department requirements and applicable federal guidelines, including the U.S Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). Services are provided to adults ages 18 and older who are homeless or at risk of homelessness. Essential Functions: Complete all required documentation—including functional assessments, reassessments, recovery plans, safety plans, and encounter notes—accurately, thoroughly, and within established timeframes, in accordance with the DMHAS Fidelity Scale. Ensure appropriate public benefits and entitlements are in place by assisting individuals with applications, renewals, and required documentation; develop monthly budgets with individuals as appropriate. Coordinate care for individuals admitted to a Higher Level of Care (HLOC) by communicating with treatment providers and participating in interdisciplinary team collaboration to support continuity of care. Provide supervision, coaching, and instruction in Activities of Daily Living (ADLs) as identified in each individual’s Recovery Plan. Provide health education to individuals as needed, including but not limited to general wellness, communicable disease prevention, and other relevant health topics. Complete a minimum of 30 hours of annual clinical in-service training and demonstrate effective use of evidence-based practices, including Stages of Change, Motivational Interviewing, and skills-based interventions; maintain knowledge of community based mutual support resources. Apply agency-required training, competency standards, documentation requirements, crisis intervention, de-escalation, emergency response, and safety procedures when providing supportive housing services. Deliver supportive housing services to individuals who are homeless or at risk of homelessness, including those without access to private or public health insurance, to ensure basic needs are met (e.g., transportation and linkage to services). Conduct comprehensive, individualized needs assessments to identify housing, clinical, medical, social, educational, rehabilitative, vocational/employment, and other support service needs. Assist individuals in obtaining and maintaining safe, stable, and appropriate housing. Coordinate and connect individuals to housing resources and community-based services that support recovery, independence, and successful community living. Collaborate with internal programs, external providers, and community partners to ensure services are delivered at the appropriate level and intensity based on individual needs. Provide services and supports for the duration necessary, guided by individualized service plans and ongoing assessment of progress and needs. Ensures client care documentation meets fidelity requirements and established Key Performance Indicators (KPIs) in accordance with program leadership guidelines. Promote quality of life, recovery, and community integration through person centered, strength based service delivery practices. Safely operates agency vehicles and/or personal vehicles for work-related travel when assigned and authorized, and follows all applicable motor vehicle and agency transportation policies. Communicates significant client concerns promptly and follows program escalation procedures. Complete timely and accurate documentation in CareLogic or other agency-required systems, including notes, schedules, incident reports, and other program records. Maintain compliance with all programmatic, departmental, state, and federal requirements related to supportive housing services. Develops and reviews recovery plans (according to policy) with person served Physical Requirements: While performing the duties of this position, the employee is required to travel throughout program settings, resident apartments, agency offices, community locations, and vehicles; climb stairs; sit; stand; walk; bend or balance as needed; use hands to handle documents, medication-related materials, cleaning supplies, phones, computers, and other work tools; and communicate effectively by phone, radio, electronic systems, and in person. Speaking and hearing ability must be sufficient to communicate with clients, staff, emergency responders, and other contacts in routine and urgent situations. Vision must be sufficient to read correspondence, computer screens, forms, medication-related materials, client records, and safety-related information. The employee must be able to lift, carry, or move items up to 25 pounds when performing program tasks such as transporting supplies, supporting apartment checks, assisting with meals, or responding to environmental needs. The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Knowledge, Skills, and Abilities: Knowledge of Supportive Housing Programs systems and recovery-oriented services. Knowledge of serious mental illness, substance use disorders, and trauma-informed care. Ability to follow written and verbal instructions. Ability to communicate clearly and respectfully with residents, coworkers, supervisors, treatment team members, and outside contacts. Ability to communicate effectively with persons served, families, staff, and community partners. Ability to use email, CareLogic, electronic records, scheduling tools, and other agency systems required for the job. Ability to remain calm, follow approved procedures, and ask for help during emergencies, crises, behavioral concerns, or other safety-related situations. Ability to organize, prioritize, document, and complete work accurately and timely. Ability to maintain confidentiality and exercise sound judgment. Proficiency in using electronic health records, Microsoft Office applications, and other agency-required systems to complete documentation, communication, and scheduling other job-related tasks. Qualifications: Minimum Education: Associate Degree in Human Services, Social Work, Psychology, Education, or related field. Minimum Experience: Two years providing care management or related behavioral health services. Additional directly related experience may be considered as a substitute for the minimum education requirement as determined by the agency based on the needs of the position. Preferred: Experience with severe and persistent mental illness in community settings. Ability to communicate verbally and in writing at a level necessary to document services, report concerns, participate in treatment team communication, and follow program requirements. Ability to use a computer to send and receive email, enter data into agency systems, and complete basic job-related electronic documentation. Current and valid driver’s license required as a condition of employment. Ability to maintain a driving record that meets agency standards and insurance requirements and to safely transport clients as required by program needs. CPR/First Aid certification required or must be obtained within the timeframe required by the agency. Successful completion of required criminal background checks, registry checks, and other agency, licensing, or funder-required screenings. Ability to work assigned shifts and meet program scheduling requirements. Equal Employment Opportunity Statement: Employment decisions are made without regard to race, color, religious creed, age, sex, pregnancy, gender identity or expression, marital status, civil union status, national origin, ancestry, citizenship, present or past history of mental disability, intellectual disability, learning disability, physical disability, including but not limited to blindness, genetic information, veteran status, sexual orientation, status as a victim of domestic violence, status as a victim of sexual assault, status as a victim of trafficking in persons, or any other characteristic protected by applicable federal, state, or local law. Other Duties: This job description is intended to describe the general nature and level of work performed by individuals assigned to this position. It is not intended to be an exhaustive list of all duties, responsibilities, or qualifications. Employees may be required to perform other job-related duties as assigned.