Case Worker

Housing & Community Support Specialist

Boston Medical Center (BMC) is more than a hospital. It is a network of support and care that touches the lives of hundreds of thousands of people in need each year. Emphasizing community-based care BMC is committed to providing consistently excellent and accessible health services to all—and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Position: Housing & Community Support Specialist

Department: Living Well at Home

Schedule: Full Time

POSITION SUMMARY:

Boston Medical Centers Living Well at Home Program (LWAH) provides high-quality housing case management services to support clients in obtaining and maintaining tenancy and living healthy lives in independent housing. As part of the LWAH team the Housing and Community Support (HCS) Specialist will provide case management services to high-risk patients with behavioral health diagnoses who are experiencing long-term homelessness. As a trusted member of the community the HCS Specialist will help patients access and obtain and stabilizing in independent housing.

JOB REQUIREMENTS:

EDUCATION:

Bachelors degree in a behavioral health or related field OR Two years of relevant work experience OR Lived experience of homelessness or behavioral health conditions

CERTIFICATES LICENSES REGISTRATIONS REQUIRED:

Drivers license and access to a car preferred. Will be required to complete community visits across Greater Boston region in a timely manner.

EXPERIENCE:

Minimum of 2 years prior healthcare public health or social services work in community-based setting

Prior experience working with individuals experiencing homelessness preferred

Prior experience working with individuals impacted by mental illness substance use disorder and/or chronic health conditions preferred

KNOWLEDGE AND SKILLS:

Basic knowledge of housing systems and passion for serving individuals who are unhoused through a non-stigmatizing patient-centered approach.

Knowledge of community resources and healthcare systems commonly used by the patient population. Preference for individual with knowledge of Boston area resources specifically.

Understanding of the social determinants of health impacting this patient population and importance in addressing them (housing food insecurity transportation etc.).

Outstanding interpersonal skills and ability to communicate in a courteous pleasant and professional manner with families and patients staff supervisors and others.

Ability to identify communicate and problem-solve issues in patient cases to improve overall care in support of patient goals.

Ability to work both independently and as part of multi-disciplinary team.

Demonstrated prudent judgement and professional presence and demeanor.

Ability to adapt to changes in care delivery at local and systems level.

Reliability commitment to setting and meeting goals is a must.

Exceptional organizational skills: ability to multi-task and prioritize tasks.

Demonstrated oral and written English communication skills.

Fluency in Haitian Creole or Spanish preferable.

Understanding of how language culture and socioeconomic circumstances affect health.

Desire to work with diverse multi-cultural and multi-lingual populations.

Proficiency with Microsoft Office applications (i.e. MS Word Excel Access Outlook) and web browsers. Proficiency with data entry and data tracking.

SPECIAL WORKING CONDITIONS (Responsible for on-call 24 hr. coverage etc.):

This role requires hybrid working conditions including community-based outreach and home visits as well as office-based work and some ability to complete work remotely at home

ESSENTIAL RESPONSIBILITIES / DUTIES:

Patient Engagement:

Visits and supports patients across Greater Boston through intensive in-home and community-based outreach.

Builds rapport trust and positive-relationships with patients through collaborative culturally-responsive patient-centered approaches.

Initiates face-to-face contact through assertive outreach with eligible patients to describe role explain participation benefits and begin screening process.

Works with patients and providers to set goals for patients housing plan and overall care and provides guidance for patient to achieve those goals utilizing skills such as motivational interviewing.

Providing patients and their support network with education educational materials and training about behavioral health and substance use disorders and recovery with support from clinical care teams.

Service and Care Coordination:

Establishes strong professional rapport with all stakeholders involved in patient case including housing providers property managers care team and other service providers.

Regularly consults with full care team including patient social work care management staff primary clinical staff behavioral health teams and other providers regarding complex patient situations demonstrating an understanding of how to solicit and incorporate feedback from a variety of stakeholders in order to continuously develop and refine the patients individualized service plan.

Mitigate any issues with tenancy promptly by collaborating with patient property manager landlord care team other service providers and other relevant parties.

Assists patient in addressing and overcoming barriers with a range of concrete supports including but not limited to: physical health behavioral health financial assistance child-care and caregiver support housing support with utility bills food financial entitlements clothing transportation food pantries violence prevention social isolation and any other appropriate community resources.

Collaborating with crisis intervention providers state agencies and outpatient providers including working with these providers to develop revise and utilize patient safety/crisis plans

Assists patients with acquiring storing and organizing files and documentation to be housing-ready.

Assists patients in obtaining housing through exhaustive housing search submission of applications mitigation of barriers on applications and support of patients with housing interviews applying a driven and relentless approach to assisting clients in obtaining housing.

Serves as the primary connection for landlords and property management through all stages of the housing process from pre-tenancy to post-tenancy stabilization.

Performance and Team Expectations:

Conducts and updates thorough needs assessment to capture all relevant patient information in compliance with MassHealth regulations.

Develops comprehensive individualized service plan with patient that is based on relevant patient needs and goals has identified housing clinical and community-based interventions and services and has clearly defined and measurable goals.

Records and monitors the participants progress toward goals within specific time frames.

Presents patients at case review meetings succinctly and logically.

Demonstrates the ability to function and communicate professionally within an inter-disciplinary team.

Ensures that documentation in all platforms (including BMCs electronic medical record) is up-to-date detailed and accurate complying with all data entry data integrity and data tracking requirements for BMC.

Develops discharge plans with patients and other providers to ensure safe and healthy transitions from services.

Participates with other staff in activities that include community outreach presentations to community organizations development of materials and staff meetings.

Attends regularly scheduled supervision and other program assigned meetings.

Participates in all training activities as designated by the Living Well at Home Director Clinical Housing Manager or Senior Operations Manager.

IND123(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

Compensation Range:22.84- 31.97

This range offers an estimate based on the minimum job qualifications. However our approach to determining base pay is comprehensive and a broad range of factors is considered when making an offer. This includes education experience skills and certifications/licensures as they directly relate to position requirements as well as business/organizational needs internal equity and market-competitiveness. In addition BMCHS offers generous total compensation that includes but is not limited to benefits (medical dental vision pharmacy) discretionary annual bonuses and merit increases Flexible Spending Accounts 403(b) savings matches paid time off career advancement opportunities and resources to support employee and family well-being. NOTE: This range is based on Boston-area data and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans

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