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Pacific Health Group

Integrated Medi-Cal care coordination provider

Community Supports Lead Care Coordinator - Housing

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeCalifornia, USA

About the Job

Requirements

  • Strong understanding of the housing system and working knowledge of local housing resources, housing navigation, community-based support programs, or transitional housing support workflows such as Medi-Cal, CalAIM, Community Supports, or HUD programs.
  • Three to five years of experience in case management, social services, or healthcare.
  • Strong understanding of healthcare systems, managed care, and community resources.
  • Strong organizational and time-management skills.
  • Proficiency with technology, including case management systems, electronic health record platforms, documentation systems, and communication tools.
  • Ability to document in real time and manage member data accurately.
  • Ability to travel locally within the hiring county, including up to 60–70% travel for in-person visits.
  • Valid California driver's license, active auto insurance meeting California requirements, and a reliable personal vehicle for daily work use.
  • Successful completion of a background check, including motor vehicle record review, and a Testlify skills assessment.
  • Reliable working laptop for the first 21 days of employment until a company-issued laptop is received.
  • Internet speed of at least 300 Mbps download and 25 Mbps upload.
  • Ability to work independently in field and remote environments, manage complex caseloads and competing priorities, and maintain meticulous, complete records of member interactions.
  • Comfort and compassion when working with individuals facing severe mental health challenges, and strong emotional intelligence and de-escalation techniques during crisis situations.

Responsibilities

  • Support members participating in CalAIM Community Supports Housing programs, including Housing Transition Navigation Services, Housing Tenancy & Sustaining Services, and Housing Deposit assistance.
  • Conduct outreach and intake assessments for members in need of housing.
  • Build partnerships with housing providers, shelters, landlords, and community organizations to improve housing access and long-term stability.
  • Provide person-centered housing care management to high-needs members, including individuals experiencing severe mental health conditions and substance dependencies.
  • Conduct home inspections and visits in shelters and community settings, and perform in-person visits, assessments, and follow-ups.
  • Manage and coordinate the housing-resource application pipeline, including processing Housing Deposit Services packages and coordinating landlord allocations.
  • Participate in community outreach events, partnerships, and local engagement to build referral routes and improve program awareness.
  • Navigate multiple primary platforms concurrently and complete accurate clinical documentation in real time in accordance with state guidelines.
  • Provide Housing Transition Navigation Services to help members move into stable long-term housing while coordinating healthcare and community services addressing housing as a social driver of health.
  • Coordinate Housing Tenancy and Sustaining Services through ongoing case management, advocacy, landlord engagement, and connections to healthcare, behavioral health, and community resources.
  • Coordinate required documentation for housing deposits and facilitate access to deposit assistance.
  • Collaborate with housing authorities, landlords, shelters, property managers, healthcare providers, and community-based organizations to support successful housing placement and long-term tenancy.
  • Monitor housing stability and proactively address barriers that could place housing or health outcomes at risk.
  • Conduct comprehensive assessments to identify members' health and social needs; develop and manage individualized housing care plans; coordinate appointments, services, and long-term housing support; and ensure continuity of care and consistent follow-through.
  • Build trusting relationships with members and their families, provide ongoing support by phone, video, and in-person visits, and advocate for timely care, services, and equitable access to resources.
  • Build and maintain relationships with community-based organizations, shelters, and service providers; identify opportunities to expand community presence and improve access; and support outreach efforts that drive engagement and program awareness.
  • Connect members to housing resources, assist with long-term housing, strengthen community-based partnerships, identify resource gaps, and escalate needs for program improvement.
  • Participate in departmental huddles, share housing resources in team channels, and provide cross-coverage support to peers.
  • Assist with new Lead Care Managers' shadowing sessions and promote consistency, collaboration, and best practices across the team.
  • Maintain accurate and timely documentation of member interactions, ensure compliance with Medi-Cal, CalAIM, and Community Supports program requirements, and track progress, outcomes, and service delivery.
  • Partner with interdisciplinary teams, including behavioral health, outreach, and social services, and coordinate with healthcare providers and payers for seamless care delivery.
  • Identify trends and service gaps and collaborate with leadership during coaching sessions to integrate feedback and refine daily workflows.
  • Manage the caseload independently, maintain member engagement, avoid gaps in care, support housing stabilization milestones, and use outreach and timely enrollment strategies to keep the caseload active and growing.

Desired Qualifications

  • Experience with Medi-Cal, CalAIM, and Community Supports programs.

About the Company

Pacific Health Group

Integrated Medi-Cal care coordination provider

Pacific Health Group provides integrated Medi-Cal care coordination in California, working with 39 health plans to serve more than 38,000 members across 44 counties. Its flagship Enhanced Care Management coordinates medical, behavioral, and social services for members with complex needs, complemented by Community Supports like housing navigation, rent assistance, medically tailored meals, and home modifications. Street Medicine reaches unsheltered individuals, while Community Health Workers provide culturally responsive care navigation and advocacy; additional services include behavioral health support, medical transportation, and a Clubhouse program for adults with mental illness. The approach follows CalAIM’s whole-person care, addressing social determinants of health to reduce fragmentation and improve stability for at-risk Medi-Cal beneficiaries.

Company size
51-200
Company stage
Not listed
Total funding
Not listed
Headquarters
Carlsbad, CA
Founded
2023

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