Clinical Case Manager

Clinical Case Manager

Triage, Consultation, and Wellness Response Team (TCWRT)

Mental Health and Wellness (MHW) Program - AB 109 Reentry Services

Agency Overview

Felton Institute responds to the needs of our community by providing innovative, evidence-informed social services that transform lives. Our organization offers 60+ programs that address mental health, the unhoused, early care and education, those impacted by the justice system, transitional age youth, as well as aging adults. Our programs combine the latest scientific research with cultural sensitivity and a deep commitment to supporting and reflecting the communities we serve. Felton offers a dynamic, challenging, and supportive work environment where we encourage the use of professional development, that staff can utilize throughout their career.

Program Description

The Triage, Consultation, and Wellness Response Team (TCWRT) is a Felton Institute program funded by the Alameda County Probation Department (ACPD) and the Alameda County Behavioral Health Department (ACBHD) under the AB 109 Mental Health and Wellness (MHW) initiative. TCWRT serves AB 109-eligible clients - including individuals released from Santa Rita Jail or CDCR facilities, and those on Post-Release Community Supervision, formal probation, or in specialty court programs - by connecting them to mental health, substance use, and wellness services. The team provides clinical consultation and triage, peer and supportive services, wellness response and de-escalation, outreach and mental health promotion, and administration of the Specialty Provider Pool (SPP). TCWRT staff are stationed across the Oakland and Hayward ACPD offices, the Center of Reentry Excellence (CORE), and AB 109 Housing Program locations, and the program operates under a detailed set of contractual reporting, data, and fiscal compliance requirements.

Position Summary

Under the supervision of the Program Manager the Clinical Case Manager carries an AB 109 caseload and provides clinical consultation, assessment, care planning, triage, provider reconnection, barrier removal, wellness response, and community outreach. This role works closely with Deputy Probation Officers (DPOs), Peer Support Specialists, in-custody providers, community behavioral health providers, and client natural supports to deliver trauma-informed, strength-based, evidence-based services.

Key Responsibilities

Clinical Consultation & Triage

• Provide clinical consultation to DPOs and AB 109 clients on mental health, substance use, and co-occurring disorder services.
• Review client clinical history via MHS 140 Intake Forms, the Social Health Information Exchange (SHIE), and other authorized records.
• Respond to referrals within 24 business hours and complete client outreach within 72 hours (targets: 100% referrer response, 100% client outreach, 70% contact rate).
• Triage clients to appropriate services (CPT, SPOT, SPP, residential treatment, psychiatry, substance use, family therapy, IPS vocational programs) within 60 days of referral activation.

Assessment, Planning & Coordination

• Conduct comprehensive information gathering from in-custody providers, psychiatric hospitals, residential programs, and primary care.
• Collaborate with DPOs and clients to identify appropriate services, considering insurance, access, presenting needs, and treatment engagement likelihood.
• Participate in case planning, care coordination, and discharge planning meetings with ACPD, in-custody providers, ACBHD, and CRSP.
• Coordinate pre-release discharge planning with Santa Rita Jail and John George Psychiatric Hospital; contact 70% of pre-release clients within 72 hours of release.
• Develop HIPAA-compliant Provider Service Plans (PSPs) within 30 days of active engagement; submit closing summaries within 30 days for immediate-triage clients; upload to the ACPD Provider Portal.

Client Engagement & Barrier Removal

• Coach and support clients resistant to engaging in mental health services; work alongside Peer Support Specialists to encourage participation.
• Address pre-contemplation and contemplation stages, build coping skills, and apply contingency management approaches.
• Support families of AB 109 clients to improve wellbeing and connect them to groups and community resources.
• Assist with barrier removal including transportation, emergency housing, insurance applications, childcare logistics, and treatment-milestone incentives.
• Help clients access psychiatry and psychiatric medication management; advocate following service or treatment denials.
• Conduct outreach to hard-to-reach clients (transient, court-ordered, conservatorship-eligible) and connect them to services within 6 months of initial referral.

Wellness Response

• Participate in the TCWRT Wellness Response system to provide intervention, de-escalation, and stabilization for clients experiencing acute mental health incidents at ACPD offices, CORE, and AB 109 Housing Programs.
• Arrive on-site within 40 minutes of request; coordinate 5150 recommendations and facilitate referrals to Crisis Residential Treatment, peer respite, or sobering centers.
• Collaborate with the SPOT team and AB 109 service providers following critical incidents or crises.

Outreach & Documentation

• Provide location-based support through rotation at ACPD offices and CORE sites; conduct community outreach and contribute to resource-sharing activities, workshops, and Community Resource Forums.
• Document all service delivery in the ACPD Provider Portal within 72 business hours; maintain consistent DPO communication; report adverse client events within 24 hours.
• Obtain and manage releases of information; contribute to monthly, quarterly, annual, and final program reports.

Minimum Qualifications

• Master's degree in social work, Counseling, Marriage and Family Therapy, Psychology, or a closely related behavioral health field from an accredited institution.
• Registered as an Associate (ASW, AMFT, or APCC) with the California Board of Behavioral Sciences, or actively licensed (LCSW, LMFT, or LPCC), in good standing.
• Minimum two (2) years of post-graduate clinical or case management experience in mental health, substance use, or co-occurring disorder services.
• Experience with justice-involved adults, including PRCS, Penal Code 1170(h), formal probation, pre-trial, or specialty court populations (strongly preferred).
• Experience navigating Medi-Cal, managed care plans, private insurance, ACCESS, and community-based behavioral health systems.

Knowledge, Skills & Abilities

• Working knowledge of Alameda County mental health, substance use, and crisis service systems, including ACCESS and ACBHD networks.
• Proficiency in Motivational Interviewing, Contingency Management, trauma-informed care, harm reduction, peer support models, and strength-based strategies.
• Knowledge of HIPAA, 42 CFR Part 2, and release-of-information confidentiality standards.
• Skilled in crisis assessment, de-escalation, and supporting 5150 procedures in coordination with licensed staff and law enforcement.
• Strong organizational, documentation, and communication skills; proficiency with electronic health records and provider portals.
• Ability to pass a Live Scan background check and obtain clearances for Santa Rita Jail and ACPD facilities.
• Valid California driver's license, reliable transportation, and proof of insurance; ability to travel throughout Alameda County.

Additional Information:

Reports to: Division Director

Job Type: Full Time

Work Schedule: Onsite

Salary Range: $90,000 - $110,000 Annually (DOE)

Benefits (subject to election and eligibility): Fully-Paid Medical and Dental Plans; Health Reimbursement Card, Paid Time Off (personal, vacation, and sick time), 403B with company match.

This position is union-represented by SEIU Local 1021 and is subject to the applicable collective bargaining agreement.

Applying Instruction:

Candidates should apply for the position at our career page "careers.felton.org" OR directly email resumes to "View email address on click.appcast.io".

IMP NOTE: Job responsibilities are subject to change according to program requirements.