YPS Care Manager

The Care Manager will implement effective prevention strategies to serve New York City’s most at-risk queer communities, with a focus on transgender, gender non-conforming (TGNC) individuals, and men who have sex with men (MSM) of color. In this dynamic role, the Care Manager will provide comprehensive care coordination for SAMHSA program participants, from enrollment to discharge. This includes conducting GRPA assessments, developing individualized care plans, and coordinating access to essential services such as primary care, mental health counseling, substance use treatment, housing, and vocational/educational resources. The Care Manager will also participate in fieldwork, outreach, and evidence-based program interventions to support clients effectively.

• Provide supportive case management to Transgender, Gender Non-conforming, and Gender Non-binary (TGNC) individuals and Men who have Sex with Men (MSM) of color who are at high risk for substance abuse and/or co-occurring mental health conditions.
  
• Conduct GRPA intake, follow-up, and discharge assessments for all program participants.
  
• Offer ongoing care coordination and participate in integrated case conferences to support treatment adherence and improved health outcomes.
  
• Follow up with clients and providers to ensure appointment adherence, engagement in care, and access to necessary treatment.
  
• Engage clients via social media for outreach, re-engagement, and case management follow-up activities in compliance with HIPAA protocols.
  
• Maintain essential data for reporting and program evaluation in eICare, including program enrollments, progress notes, care plans, and referral activity.
  
• Build and maintain comprehensive resource lists for external services and emergency resources (e.g., housing, domestic violence support, food pantries).
  
• Coordinate with outreach staff to identify and address the needs of new enrollees in the program.
  
• Facilitate presentations for internal and external programs to promote program services and attract new enrollees.
  
• Participate in weekly supervisory sessions with the Program Coordinator.
  
• Contribute to monthly chart reviews and participate in Continuous Quality Improvement (CQI) site meetings and programmatic projects.
  
• Ensure successful referrals and linkages to psychosocial services, including warm hand-offs.
  
• Participate in daily huddles with clinic staff to discuss client needs and coordinate care as needed.
  
• Collaborate with multidisciplinary team members and external partners to address clinical barriers to care.
  
• Perform various administrative duties, including updating client trackers, outreach logs, assisting with outreach calls, and scheduling intakes and follow-ups.
  
• Attend interdisciplinary team meetings as a program representative and provide updated information in preparation for meetings.
  
• Perform other duties as assigned by the supervisor to support program goals.
  

Minimum Requirements

• High School Diploma or GED required; Bachelor's degree in Social Work, Public Health, Human Services, or a related field preferred.
  
• Strong computer skills, including proficiency in Microsoft Word, Excel, Electronic Record Systems, Outlook, and other relevant software.
  
• Demonstrated social media outreach and engagement skills to effectively connect with clients and promote program services.
  
• Ability to work regular evenings and several weekends per year; flexibility with schedule and travel required for outreach events and fieldwork around the city.
  
• Minimum of 2 years of experience in case management, care coordination, or working with LGBTQ+ communities, particularly TGNC individuals and MSM.
  
• Bilingual in Spanish preferred.
  
• Experience with conducting intakes, assessments, and developing care plans.
  
• Knowledge of substance use treatment, mental health counseling, and HIV prevention strategies.
  
• Ability to engage effectively with clients via social media while adhering to HIPAA protocols.
  
• Strong documentation skills with experience using electronic health records (EHR) systems such as eICare.
  
• Familiarity with community resources and services in New York City.
  
• Excellent communication, organizational, and presentation skills.
  
• Ability to work both independently and as part of a multidisciplinary team.
  
• Willingness to engage in fieldwork, including visiting clients in their homes, meeting at community locations, and participating in outreach events.
  
• Commitment to cultural competency and sensitivity in working with diverse populations.
  
• Valid driver's license and ability to travel within NYC preferred.
  
• Professional experience with social media, dating apps, and other digital marketing tools is preferred, with a willingness to develop these skills.
  

Housing Works was founded in 1990 with a long-term commitment to AIDS advocacy. Housing Works established New York State’s first harm reduction-based, OASAS-licensed outpatient drug treatment program. Other services include Health Home care management, behavioral health, and syringe exchange programs.

A pioneer in the social entrepreneurship movement, Housing Works operates 10 high-end thrift shops in Manhattan and Brooklyn and a much-loved Bookstore Cafe in Soho. Housing Works fights for funding and legislation to ensure that all people living with HIV/AIDS have access to quality housing, healthcare, HIV prevention, and treatment, among other lifesaving services. For more information, visit www.housingworks.org.

• COVID-19 Vaccination Requirement: Housing Works requires employees working in our Health Services division to be fully vaccinated against COVID-19, unless approved for a legal accommodation. If you need an accommodation for any reason, including related to this job requirement, please contact Human Resources.
  
• Fraud Alert: Job candidates should be aware that scammers may pose as employers and create fake job postings in order to extract personal information from individuals for financial gain. Housing Works will never ask job candidates for personal information, such as social security numbers or bank account details, over the phone. If you suspect that a job posting may be fake or wish to confirm that a job posting from Housing Works is genuine, please contact us at recruitment@housingworks.org.
  

• We have three comprehensive healthcare plans to choose from based on your priorities and budget. Housing Works covers most of the plan; you pay a portion, based on your salary.
  
• Staff begins accruing PTO immediately for a total of up to 30 days earned in the first year.
  
• We offer employees an educational benefit. This money is available for tuition loan reimbursement, tuition costs, and textbooks.
  

Housing Works provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Housing Works complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. Housing Works also does not request prior salary information during the hiring process. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

This position is included in a bargaining unit of Housing Works’ New York City employees represented by a labor union known as the Retail Wholesale and Department Store Union (“RWDSUâ€). Accordingly, the RWDSU has the exclusive right to bargain over the terms and conditions of employment related to this position and this position may become covered by the terms of a collective bargaining agreement (a “CBAâ€) between Housing Works and the RWDSU.