Community Supports Lead Care Coordinator (Housing)

At Pacific Health Group, we are at the forefront of revolutionizing health and wellness through innovation, compassion, and community-driven care. Our mission is to empower members, uplift families, and positively impact the communities we serve. Our Community Supports (CS) Program helps Medi-Cal members live more independently by addressing health-related social needs. In this role, you won’t just create care plans—you’ll guide members through every step of their journey, ensuring they receive the support and services needed to thrive. This is a highly field-based role supporting members directly in the community.

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 complete intake assessments for members in need of housing; Build strong partnerships with housing providers, shelters, landlords, and community organizations; Provide comprehensive, person-centered housing care management to a diverse panel of high-needs members; Spend approximately 50% of time in the field; Conduct in-person visits, assessments, and follow-ups; Manage and coordinate the application pipeline for housing resources, including processing HDS packages and coordinating landlord allocations; Participate in community outreach events and partnerships; Complete high-fidelity chart notes and clinical documentation in real-time; Develop and manage housing individualized care plans; Coordinate housing transition navigation, tenancy sustaining services, and deposit assistance; Collaborate with housing authorities, landlords, shelters, property managers, healthcare providers, and community-based organizations; Advocate for timely care, services, and equitable access to resources; Maintain accurate and timely documentation and ensure compliance with Medi-Cal, CalAIM, and Community Supports program requirements

Requirements

Strong understanding of the housing system and demonstrated 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); Experience: 3–5 years in case management, social services, or healthcare; Strong understanding of healthcare systems, managed care, and community resources; Excellent communication, empathy, and cultural competence; Strong organizational and time management skills; Must be proficient in technology, including case management systems, EHR platforms, and documentation tools; Ability to document in real-time and manage member data accurately; Comfortable navigating multiple systems and communication platforms; Ability to travel locally within Mendocino County; Valid California Driver’s License and reliable transportation; Ability to work in a hybrid, field-based environment

Nice to have

Experience with Medi-Cal, CalAIM, and Community Supports programs; comfortable working independently in the field and remote environments; strong emotional intelligence; proven de-escalation techniques; detail-oriented and enjoys multitasking

Benefits

Monthly stipend; 160 hours PTO + paid sick time; 11 paid holidays (including birthday and floating holiday); 4 paid volunteer hours per month; 90% employer-paid employee-only medical benefits; Flexible Spending Account (FSA); Short-term & long-term disability, AD&D; Employee Assistance Program (EAP); 401(k) with company match; Professional development opportunities; Quarterly in-person events; Employee discount programs