• Provide individualized community outreach as a key member of the multi-disciplinary support team.
• Deliver side-by-side interventions focused on problem-solving, skill-building, and positive reinforcement.
• Model appropriate coping and life skills to encourage personal growth and resilience.
• Collaborate with each individual and the team to develop and implement a person-centered treatment plan.
• Support individuals in building natural community supports to promote inclusion and independence.
• Empower clients to take control of their treatment, leisure activities, employment, and overall recovery journey.
• Foster optimism, motivation, and confidence in individuals as they work toward their personal goals.
• Ensure continuity of care by maintaining open communication with the team and community partners.
• Provide on-call support during evenings and weekends to address client needs promptly.

Skills: Community Outreach, Client Empowerment, Crisis Intervention, Skill Development, Treatment Planning, Team Collaboration, Communication and Coordination, Emotional Support

• Meet individually with clients to conduct thorough intake assessments and identify service needs.
• Advocate for clients in accessing identification, housing, benefits, and entitlements from public and private agencies.
• Coordinate referrals and linkages to community resource programs that support client stability and independence.
• Collaborate with team members to develop individualized case plans tailored to each client’s goals and challenges.
• Document client interactions and progress daily in the county database to ensure accurate recordkeeping and compliance.
• Maintain up-to-date and organized client files to support effective case management.
• Enter all relevant client data into Next Gen and HIMS systems in a timely and accurate manner.
• Attend regular team and management meetings to review cases and discuss program updates.
• Participate in stakeholder meetings to support collaboration and service coordination.

Skills: Client Assessment, Advocacy, Resource Coordination, Case Planning, Documentation, Data Entry, Record Management, Team Collaboration

• Provide coordinated support to individuals and families by organizing service activities and helping clients establish self-identified goals.
• Develop individualized service plans (ISPs) for all participants and monitor progress through regular treatment reviews.
• Engage with clients, families, and key support persons through consistent face-to-face visits and phone contact.
• Educate clients and families on available treatment services and assist in selecting appropriate options to meet ongoing needs.
• Support stabilization efforts following crises by facilitating continuity of care and coordination of services.
• Participate in the rotational on-call schedule to provide emergency coverage and crisis intervention.
• Communicate critical situations to supervisors and relevant team members promptly for appropriate follow-up.
• Maintain accurate, detailed, and compliant documentation of all services and activities, including weekly billing reports.
• Ensure client and family signatures are obtained on all relevant records and reports to confirm service delivery.
• Prepare and submit service need reports and treatment reviews in compliance with program, state, and local regulations.
• Assist with client admissions and ensure all required intake documentation is properly completed.
• Support legal, licensing, regulatory, and certification processes to maintain program compliance and quality standards.

Skills: Client Support, Service Planning, Family Engagement, Crisis Intervention, Care Coordination, Documentation, Compliance, Communication

• Promote and model workplace values of integrity, innovation, empowerment, respect, and personal growth in alignment with organizational standards.
• Conduct comprehensive assessments to identify participant needs related to housing, employment, finances, health, and family adjustment.
• Coordinate and customize services to address each participant’s unique goals and circumstances.
• Work collaboratively with individuals, families, or small groups to develop actionable service and improvement plans.
• Advocate for participants by facilitating referrals to community resources, human services, and partner organizations.
• Identify and contribute to the development of supportive services that enhance participants’ job readiness.
• Provide training and guidance on resume writing, job searches, and interview preparation to promote employment success.
• Maintain detailed case records and prepare reports to document participant progress and service outcomes.
• Complete administrative responsibilities, ensuring accurate and timely data entry across all required databases.
• Review and evaluate service plans regularly to assess effectiveness and participant satisfaction.
• Maintain updated knowledge of community resources and ensure accessibility for participants.
• Collect and organize relevant documentation such as employment histories, school records, and medical reports.
• Analyze the effectiveness of existing resources and recommend improvements to enhance service quality and outcomes.

Skills: Integrity & Leadership, Needs Assessment, Service Coordination, Client Advocacy, Job Readiness, Career Coaching, Case Management, Program Evaluation

• Ensure all client intakes and assessments are completed in full compliance with program protocols, including conducting mental health screenings and training staff and interpreters.
• Develop and implement individualized service plans for eligible clients, ensuring timely reviews and case closures in accordance with program standards.
• Provide solution-focused counseling and crisis intervention support to clients experiencing immediate or ongoing challenges.
• Assign trained mentors to at least half of the eligible client population and maintain accurate documentation of mentorship activities.
• Deliver Enhanced Cultural Orientation sessions to help special populations integrate successfully into U.S. society.
• Advocate for refugee clients and ensure equitable treatment consistent with the agency’s mission of dignity and respect for all individuals.
• Collaborate with New Mexico refugee resettlement staff to design and implement training protocols that strengthen referral processes and staff cultural competency.
• Participate in community outreach events to connect target populations with available resources and support services.
• Facilitate educational group sessions, community meetings, and one-on-one discussions to increase awareness of local opportunities.
• Maintain comprehensive client case notes and ensure timely, accurate documentation of all services provided.
• Submit required program data and reports promptly while upholding agency quality assurance and HIPAA standards.
• Ensure all services and activities comply with federal, state, and agency contractual and accreditation requirements.

Skills: Client Assessment, Service Planning, Crisis Counseling, Mentorship Coordination, Cultural Orientation, Client Advocacy, Community Outreach, Compliance Management

• Experience in case management, social work, or a related human services field.
• Strong commitment to supporting refugees and immigrants in achieving self-sufficiency.
• Ability to manage detailed and confidential information independently with minimal supervision.
• Skilled in building rapport and maintaining trust with individuals from diverse cultural and linguistic backgrounds.
• Flexibility and strong problem-solving abilities in dynamic environments.
• Collaborative mindset with the ability to work effectively within a team to meet shared goals.
• Excellent written and verbal communication skills.
• Ability to work remotely and effectively use virtual communication tools such as Zoom.
• Willing to work flexible hours, including evenings, weekends, and early mornings.
• Proficient in one or more refugee languages, such as Kinyarwanda, Swahili, Arabic, Farsi, Spanish, Chin, Burmese, French, or Tigrinya.

Qualifications: BA in Sociology with 2 years of Experience

• Experience in trauma-informed case management, with the ability to manage multiple and competing priorities.
• Experience conducting psychosocial assessments and developing individualized service plans.
• Background in crisis intervention and de-escalation techniques in community or shelter settings.
• Experience collaborating with multidisciplinary teams, including mental health professionals, housing coordinators, and healthcare providers.
• Familiarity with navigating community resources, benefits systems, and social service agencies.
• Awareness of confidentiality laws (HIPAA, FERPA, etc.) and ethical standards in social services.
• Familiarity with data collection, outcome measurement, and reporting processes.
• Strong communication skills, including the ability to work effectively with individuals who are preliterate or learning English.
• Proficiency in computer use and written documentation to maintain accurate and organized case files.
• Flexible to adapt work schedules based on client needs and availability.
• Willing to work evenings and weekends.

Qualifications: BA in Behavioral Science with 4 years of Experience

• Clinical nursing experience in complex case management.
• Active Registered Nurse (RN) license in the state of practice, preferably multi-state licensure.
• Experience in complex case management within a managed care environment.
• Experience working with patients managing chronic kidney disease (CKD) or end-stage renal disease (ESRD).
• Comprehensive knowledge of clinical nursing principles and practices.
• Strong understanding of case management principles and practices, including NCQA standards.
• Familiar with care management, coordination processes, and evidence-based practice guidelines for developing care plans.
• Ability to apply clinical judgment, analytical thinking, and problem-solving in complex situations.
• Strong organizational and time management skills with the ability to handle multiple priorities effectively.
• Proficiency in interpreting and applying healthcare policies, regulations, and standards.
• Ability to review and evaluate medical records and healthcare data accurately.
• Demonstrated ability to work independently while maintaining strong collaboration within interdisciplinary teams.
• Compassionate and skilled approach to supporting patients with complex and chronic health needs.

Qualifications: BS in Public Health with 5 years of Experience

• Knowledge of public benefits programs and the ability to assess eligibility for various assistance options.
• Experience providing intensive case management for individuals with complex and urgent needs in settings such as outpatient behavioral health or crisis response programs.
• Familiar with community-based resources and service networks, including programs supporting seniors, adults with disabilities, and individuals in crisis.
• Experience in conducting risk assessments, managing high-risk situations, and evaluating program outcomes.
• Ability to apply evidence-based clinical practices such as motivational interviewing, de-escalation, conflict resolution, and crisis support.
• Skilled in facilitating communication between residents and property management to support housing stability.
• Confident in leading and actively participating in interdisciplinary and interagency meetings with residents and community partners.
• Ability to promote and coordinate integrated primary and mental health care with external providers.
• Experience building and maintaining collaborative relationships with community agencies to ensure clients’ access to resources and services.
• Proficiency in crisis response and critical incident support, including triage, safety assessment, psychiatric evaluation, and coordination with emergency or protective services.
• Ability to provide follow-up care and prevention planning after crises, collaborating with community providers to ensure continuity and coordination of care.

Qualifications: BA in Social Work with 7 years of Experience

• Understanding and sensitivity to issues related to homelessness, substance use, mental health, and aging among low-income populations.
• Knowledge and experience in advanced case management, including trauma-informed care, harm reduction, crisis intervention, and motivational interviewing.
• Ability to provide intensive case management to individuals with complex and urgent needs, demonstrating confidence, compassion, and empathy.
• Strong analytical, problem-solving, and follow-through abilities.
• Experience collaborating with social service agencies and interdisciplinary teams.
• Ability to provide culturally responsive support to diverse populations.
• Experience serving vulnerable groups, including individuals and families facing mental health or substance use challenges, formerly homeless persons, veterans, youth, immigrants, and seniors.
• Knowledge of crisis response, intervention, and mandated reporting procedures for child and elder abuse.
• Experience advocating for clients in accessing identification, housing, benefits, and entitlements from public or private agencies.
• Experience working in a permanent supportive housing setting, coordinating with property management to support housing stability and retention.
• Awareness of and sensitivity to the unique needs of low-income communities.
• Proficiency in crisis de-escalation and application of the harm-reduction model.

Qualifications: BA in Human Services with 6 years of Experience