The posting
This is a union eligible position. JOB SUMMARY HealthRIGHT 360, a nonprofit organization and a family of programs, is committed to providing accessible and comprehensive healthcare services to vulnerable populations. Our mission is to tackle systemic barriers to healthcare and promote health equity for all. We offer a wide range of services, including mental health care, residential and outpatient substance use treatment, and primary health services. Additionally, we provide transitional support for individuals re-entering the community after involvement in the criminal justice system. By integrating physical and behavioral health, we empower individuals to overcome challenges by addressing social determinants of health, fostering resilience, and facilitating recovery. The 815 Residential and Detox Program The program fully integrates substance use disorder and mental health services; beyond merely providing both services under the same roof or cross-training staff, it adopts a model of providing effective services to the targeted needs of individuals with co-occurring disorders. The program treats both problem types as primary and assists participants to recognize key reciprocal factors such as self-medicating strategies; physiological and psychological changes associated with long-term substance use; and the impact of street drugs on mental health symptoms. The Residential Case Manager is a vital member of the treatment team, responsible for ensuring seamless service coordination for clients receiving substance use disorder (SUD) treatment within HealthRIGHT 360’s residential programs under the Drug Medi-Cal Organized Delivery System (DMC-ODS) in San Francisco. This role focuses on care coordination, referral and linkage, transition planning, medication management support, and interdisciplinary collaboration to support clients’ recovery and successful reintegration into the community. KEY RESPONSIBILITIES Care Coordination & Client Advocacy
Conduct comprehensive assessment of case management needs and utilize information in the clients’ American Society of Addiction Medicine (ASAM) Assessment to determine and provide appropriate care coordination services. Support clients in obtaining and maintaining benefits including Medi-Cal. Develop individualized care coordination goals for clients’ treatment plans that align with clients’ needs, preferences, and recovery goals, ensuring integration with co-occurring mental health and medical services when applicable. Monitor and track clients’ progress toward care coordination goals, making adjustments to care plans based on evolving needs and treatment responses. Collaborate with the clients’ treatment team to ensure appropriate use of case management business passes that do not interfere with clients meeting daily treatment requirements. Serve as the primary point of contact relating to care coordination needs for clients, their families (when appropriate), and internal and external service providers to ensure a holistic, client-centered approach to care. Completes all Releases of Information.
Referral & Linkage to Support Services
Facilitate linkage to internal and external community resources, social services, medical care, mental health care, and housing to support clients in accessing and utilizing services to meet their care coordination goals and support long-term recovery. Facilitate linkage to lower or higher levels of care when clinically indicated. Coordinate warm handoffs to outpatient treatment providers, mental health professionals, and other community-based resources to provide a supported transition out of residential care and into lower level of care. Advocate for clients’ rights and access to necessary services, ensuring that cultural and linguistic needs are met.
Transition Planning & Abstinence Protection Planning Support
Develop aftercare and discharge plans that prioritize continued care engagement and relapse prevention strategies. Transition planning and preparation for enrollment in education or employment programs after residential treatment. Participates in weekly reauthorization team meetings regarding ongoing medical necessity, facilitates identified linkages, and facilitates transition planning. Collaborate with therapists, case managers, housing navigators, and any providers involved in clients’ care to coordinate continuity of ongoing aftercare services and assist clients in successfully reintegrating into the community. Conduct follow-up coordination with clients within 14 days post-discharge to monitor successful linkage to aftercare services and encourage continued participation in treatment.
Healthcare Coordination
Assist clients in scheduling and attending medical, MAT, dental, and psychiatry appointments as well as follow-up and specialty care appointments and supports clients in picking up medications to teach clients skills to independently manage their healthcare while navigating triggers in the community. Support clients in completing SDI applications as needed. Coordinate transportation for in-person appointments and connect clients remotely for telehealth appointments. In the event of hospitalization, communicate with hospital and HR360 medical leadership to determine hospital discharge timeline and appropriate level of care following hospital discharge.
Collaboration & Compliance
Maintain open and timely communication and collaboration with multidisciplinary treatment teams, including therapists, case managers, medical staff, and social workers. Ensure accurate and timely documentation of services provided, including progress notes, assessments, referrals, treatment updates, and transition and discharge documents in compliance with DMC-ODS billing and documentation guidelines. In addition to care coordination services, facilitates and documents client group activities, psychoeducation and clinical groups, as well as individual counseling services as needed. Meets service delivery expectations. Responsible for ensuring a safe and orderly treatment environment for clients, staff, and visitors which includes crisis management and de-escalation, emergency response, overdose prevention and response, safety checks to account for the well-being of all clients at least hourly, property searches, substance use testing, nexus/front desk duties, monitoring meal periods, incident reporting and other required documentation. Participate in case reviews, team meetings, staff and agency meetings, and audits to ensure adherence to program standards and continuous quality improvement. Participates in and completes all training.
And perform other duties as assigned. QUALIFICATIONS Education, Certification, Licensure
High school diploma or equivalent required. Bachelor's degree in a related field preferred. A minimum of 1 year of experience in care coordination, case management, or substance use disorder services, preferably within a residential or community-based setting. AOD Registration from an Accredited authority (CCAPP, CADTP, CAADE) is required. AOD Certification from an Accredited authority (CCAPP, CADTP, CAADE) is preferred. First Aid and CPR certification. A valid California driver’s license.
Knowledge and Skills
Understanding of substance use disorders, co-occurring mental health conditions, harm reduction, trauma-informed care, and recovery-oriented systems of care. Familiarity with ASAM Criteria, DMC-ODS regulations, and Medi-Cal billing procedures is highly preferred. Strong interpersonal and communication skills, with the ability to build rapport with diverse populations and advocate for clients' needs. Ability to work effectively in a fast-paced, collaborative, and client-centered environment.
