Case Manager ( Pathway Home )

About the Role

This position serves as an Experienced Case Manager on a New York State Office of Mental Health (OMH) funded Adult Home Care Transition team. The team exclusively supports class members transitioning from Adult Homes to community living. The role is designed to address preparatory needs during early discharge planning, focusing on developing daily living skills and coping mechanisms through both group and individual work within the Adult Home setting.

Following the Pathway Home model of care, the team accompanies class members into the community to ensure they become linked and engaged with identified providers. The goal is to verify that each individual's support network is sufficient to meet their needs, fostering independence and stability.

Day in the Life

You will engage with participants directly in the Adult Home to conduct needs assessments essential for community integration. Your work involves facilitating individual or group support sessions focused on prevention, mental and emotional health, and preparation for independent living. This may include assisting individuals with challenges related to addiction, substance use, family dynamics, stress management, medication management, and housing readiness.

A significant portion of the role involves active community navigation. You will accompany members to their first behavioral health and medical appointments, provide travel training, and assist in re-engaging them with community care. You will act as a liaison between the Department of Health, Managed Care Plans, and Housing Contractors to resolve clinical issues impacting housing retention and to expedite community housing placements.

You will also collaborate closely with Adult Home administrative staff, housing contractors, and peer specialists to plan appropriate transitions. Responsibilities include developing short-term, person-centered treatment plans, monitoring progress, and providing intensive emotional and practical support. The role requires on-call coverage and a willingness to work flexible hours to provide out-of-hours crisis intervention, respite referrals, and stabilization services.

Hiring Process

Candidates must possess a Bachelor's Degree in a Human Service discipline and a minimum of two years of case management experience in a social service agency. Experience providing direct services to persons with Serious Mental Illness, developmental disabilities, and/or substance use disorders is preferred. Selected candidates will be expected to comply with all required in-service training and staff development protocols.