Community Health Home Care Manager — Advocate & Navigator

New Horizon Counseling Center, Inc.; Copiague (NY); On-site; USD 45,000 - 55,000; Full time

Job summary

New Horizon Counseling Center is seeking a Health Home Care Manager to help individuals with complex medical, behavioral health, and social needs live in the community. This is a hands-on, community-based role focusing on outreach, advocacy, and coordination across providers.

You will assess client needs, develop individualized care plans, connect with housing, benefits, and health services, and support transitions from hospital to community.

Qualifications

• Bachelor's degree in a relevant field is required.
• Direct human services experience is preferred (minimum 1 year).
• Strong communication, organization, documentation, and advocacy skills are essential.
• Willingness to travel regularly throughout the community.

Responsibilities

• Engage clients in the community through face-to-face outreach and regular contact.
• Complete initial and ongoing assessments to identify client strengths, needs, goals, and barriers.
• Develop and implement individualized care plans with clients and their providers.
• Coordinate appointments and follow-up care with primary care, behavioral health, hospitals, rehabilitation facilities, and other providers.
• Assist clients transitioning from hospitals, emergency departments, or rehabilitation programs back into the community.
• Identify and address gaps in care, including missed appointments, medication concerns, and unmet healthcare needs.
• Connect clients to resources addressing housing, food insecurity, transportation, benefits, employment, and other social determinants of health.
• Assist clients with accessing benefits and community resources such as SSI/SSD, SNAP, HEAP, Medicaid, housing programs, and other supportive services.
• Advocate for clients and help them navigate complicated healthcare and social service systems.
• Collaborate with providers, family members, community agencies, and other members of the client's care team.
• Maintain accurate and timely documentation, care plans, assessments, and required reports.
• Travel regularly throughout the community to meet with clients and providers

Skills

Communication

Organization

Documentation

Advocacy

Education

Bachelor's degree in Social Work, Human Services, Psychology, Public Health, or related field

Job description

New Horizon Counseling Center is seeking a Health Home Care Manager to help individuals with complex medical, behavioral health, and social needs live in the community. This is a hands-on, community-based role focusing on outreach, advocacy, and coordination across providers.

You will assess client needs, develop individualized care plans, connect with housing, benefits, and health services, and support transitions from hospital to community.