Complex Needs Case Manager

FIRST PRESBYTERIAN CHURCH - STEWPOT; Dallas (TX); On-site; USD 48,000 - 64,000; Full time

Job summary

The Stewpot, in partnership with Housing Forward, seeks a Complex Needs Case Manager to provide intensive, person-centered services to neighbors experiencing homelessness with high and complex needs in Dallas.

The role focuses on building trusting relationships, coordinating care across systems, and advancing housing placement and stability through individualized service plans and trauma-informed practices.

Qualifications

• Bachelor's degree in Social Work, Psychology, Sociology, Human Services, Behavioral Health, or related field preferred.
• Experience providing case management to individuals experiencing homelessness or complex needs preferred.
• Knowledge of homelessness, housing systems, behavioral health services, and community resources.

Responsibilities

• Maintain an assigned caseload of neighbors with high or complex service needs.
• Develop individualized service plans and coordinate care across multiple systems.
• Assist with obtaining essential identification documents and housing placement tasks.
• Collaborate with housing providers, behavioral health and healthcare partners to support housing stability.

Skills

Case management

Homelessness experience

Crisis intervention

Interpersonal skills

Coordination across agencies

Education

Bachelor's degree

Tools

HMIS

Job description

Position SummaryThe Complex Needs Case Manager provides intensive, person-centered case management to neighbors experiencing homelessness who have high and complex service needs, including serious mental health needs, chronic health conditions, housing instability, and other barriers to achieving and maintaining housing stability.Working as a member of The Stewpot team and under the program direction and coordinated care framework of Housing Forward, the Complex Needs Case Manager works closely with partner agencies including DDI, Metrocare Services, Parkland Health, Housing Forward, housing providers, behavioral health providers, and other community partners.This position serves neighbors who may require a higher level of coordination and engagement than traditional case management. The Complex Needs Case Manager is responsible for building trusting relationships, developing individualized service plans, coordinating care across multiple systems, reducing barriers to housing and services, and supporting neighbors as they move toward housing stability, improved wellness, and greater independence.The position requires strong relationship-building skills, sound judgment, persistence, flexibility, and the ability to effectively work with individuals experiencing significant behavioral health and other complex challenges.Essential Duties & ResponsibilitiesIdentification Case Management & Neighbor EngagementMaintain an assigned caseload of neighbors identified as having high or complex service needs.Build trusting, consistent relationships with neighbors who may have historically experienced difficulty engaging with traditional service systems.Provide individualized case management focused on helping neighbors obtain, replace, or update essential identification documents.Assess identification-related needs, barriers, and eligibility requirements and develop individualized action plans.Assist with applications for birth certificates, state-issued identification cards, Social Security cards, and other essential documents.Help neighbors gather required documentation, complete forms, schedule appointments, and navigate government and community service systems.Follow up consistently with neighbors and service providers to monitor progress and resolve barriers.Develop individualized service plans with neighbors based on their priorities, strengths, barriers, and housing goals.Provide services using a person-centered, trauma-informed, strengths-based, and housing-focused approach.Help neighbors navigate barriers that may interfere with housing placement or housing stability.Behavioral Health & Complex Needs CoordinationWork closely with neighbors experiencing significant mental health needs, behavioral health challenges, substance-use concerns, chronic medical conditions, or multiple co occurring needs.Recognize changes in behavior or circumstances that may indicate the need for additional clinical, medical, or crisis intervention.Coordinate with qualified behavioral health and healthcare professionals rather than attempting to provide clinical services outside the scope of the position.Facilitate connections to mental health treatment, primary care, medication management, substance-use services, benefits, and other appropriate resources.Participate in multidisciplinary discussions regarding neighbors with particularly complex needs.Collaborate with community partners to coordinate and support neighbors’ attendance at appointments, including transportation arrangements, appointment reminders, and follow up to address barriers to successful participation.Housing StabilitySupport neighbors in maintaining housing stability by identifying immediate needs, barriers, and available community resources.Assist neighbors experiencing housing instability by connecting them with emergency and ongoing supportive services.Connect neighbors with local food pantries, meal programs, food assistance benefits, and other community food resources.Coordinate the distribution or provision of clothing, personal hygiene products, household essentials, and other basic-needs supplies.Coordinate with Housing Forward, housing providers, landlords, and other partners involved in the neighbor's housing plan. Support newly housed neighbors during the transition from homelessness into housing.Identify risks that could lead to housing loss and coordinate interventions as early as possible.Help neighbors develop skills and connections that support long-term housing stability.Crisis Response & SafetyRecognize and appropriately respond to behavioral health crises and other situations requiring immediate intervention.Follow established Stewpot and partner protocols for crisis response and escalation.Coordinate with behavioral health professionals, healthcare providers, emergency services, security, or other appropriate resources when necessary.Maintain professional boundaries while providing compassionate and persistent engagement.Complete incident reports and required follow-up documentation. Immediately communicate significant safety concerns according to established procedures.Documentation & Data ManagementMaintain timely, accurate, and professional case notes.Document assessments, contacts, referrals, services, progress, barriers, and outcomes.Enter required information into HMIS and/or other designated systems in accordance with program requirements.Maintain documentation necessary for grants, contracts, audits, and program compliance.Protect confidential neighbor information and follow applicable privacy requirements.Track neighbor progress from engagement through housing placement and housing stabilization.Participate in case reviews and quality-assurance activities.Required QualificationsBachelor's degree in Social Work, Psychology, Sociology, Human Services, Behavioral Health, or a related field preferred. Equivalent relevant experience may be considered.Experience providing case management to individuals experiencing homelessness, serious mental health needs, behavioral health challenges, or other complex circumstances strongly preferred.Knowledge of homelessness, housing systems, behavioral health services, healthcare resources, and community-based services.Demonstrated ability to work effectively with individuals who may be difficult to engage through traditional service models.Strong crisis-management, problem-solving, communication, and interpersonal skills.Ability to coordinate effectively across multiple organizations and disciplines.Strong documentation and organizational skills.Ability to maintain appropriate professional boundaries and confidentiality.Experience with HMIS or comparable case-management systems preferred.Valid driver's license and ability to travel throughout the community as required.