Case Manager I, Health Systems Navigation

Role Summary

The Health Systems Navigation (HSN) Case Manager provides comprehensive, client-centered case management with a harm reduction focus to individuals who use substances. This role facilitates seamless access to and retention in a full spectrum of health services, including primary care, behavioral health, substance use treatment, and HIV/HCV/STI prevention and care. Responsibilities include conducting outreach, testing, counseling, and support groups, with a primary focus on re-engaging participants who are newly diagnosed or have fallen out of care. By managing a dedicated caseload and developing individualized care plans that prioritize client-identified goals (such as improving health, securing housing, and accessing social services), the Case Manager supports participants on their journey toward improved health, stability, and self-sufficiency.

Responsibilities

• Conduct client intakes and assessments to identify strengths, needs, and barriers to care.
• Develop, implement, and update individualized care plans in collaboration with clients to achieve their health, housing, income, and stability goals.
• Provide ongoing, strengths-based case management and consistent follow-up to a dedicated caseload to support progress toward care plan objectives.
• Coordinate internal and external services, including medical care, behavioral health, substance use treatment, and housing, and assist clients in obtaining vital documentation and public benefits.
• Provide confidential HIV/HCV/STI risk reduction counseling, and risk assessment and disclosure sessions using evidence-based approaches to people seeking confidential HIV/HCV/STI testing.
• Build a positive rapport with clients through the compassionate and non-judgmental application of harm reduction and trauma-informed principles.
• Serve as the primary point of contact for linkage-to-care referrals for clients who test positive for HIV/HCV/STI, ensuring a warm handoff and supportive follow-up.
• Facilitate harm reduction and health education support groups on a regular basis.
• Conduct targeted outreach and engagement in various community settings, including SROs, shelters, and via GLIDE's mobile testing team, to identify and connect with clients across SF.
• Represent GLIDE at community events, health fairs, and partner meetings to promote program services and collaborative care.
• Maintain accurate, timely, and confidential client records and case documentation in compliance with HIPAA and program standards.
• Complete all required data entry in designated databases (e.g., Salesforce) to capture contract deliverables and support reporting.
• Actively participate in care coordination meetings with internal and external partners to ensure integrated service delivery.
• Engage in regular supervision, team meetings, and professional development training.
• Prepare and submit monthly activity and data reports to capture program deliverables.
• Serve as the primary contact for linkage-to-care referrals for clients testing positive for HIV/HCV/STI, ensuring warm handoffs.
• Adhere to professional boundaries, ethical standards, and HIPAA protocols.
• Develop and prepare culturally appropriate outreach and educational materials to promote program services.
• Support and participate in the full range of HEAT program services and special events.
• Conduct consistent follow-ups (e.g., office, outreach, phone) to support client goals and document progress.

Requirements

• Bachelor’s degree in social work, public health or related field and/or 2+ years providing harm reduction focused case management services to high-risk populations, including knowledge providing prescriptions for suboxone, naltrexone and other medications (and methadone dispensaries) used to support treatment adherence for clients who access HEAT MOUD services.
• Must have extensive knowledge of the prevention and treatment of HCV, HIV, and STIs.
• Ability to plan and implement outreach objectives in alignment with HEAT program needs and to promote HEAT program objectives.
• Ability to establish and maintain effective collaborative relationships across GLIDE programs, city agencies, and community partners across San Francisco and the wider Bay Are
• Understanding of core principles and practices of harm reduction and successfully engage clients in services and retention through the application of risk reduction counseling, strengths-based counseling techniques and trauma informed systems of care.
• Knowledge of the Social Determinants of Health (SDOH) and ability to provide culturally competent, culturally sensitive support to a diverse community of clients to help them achieve stability and self-sufficiency.
• Strong communication skills and trust-building skills are required, including comfort and proficiency with public speaking (i.e. 1:1 interaction with clients, group education, street outreach, etc.)
• Experience and training in overdose reversals, de-escalation techniques, motivational interviewing, and other relevant skills in managing chaotic environments

Certificates, Licenses

• California Rapid HIV/HCV/STI test counselor certification preferred OR willingness to be trained.
• Current California driver’s license preferred.
• Certified Phlebotomist preferred.
• Proficiency and accuracy in math.
• Proficient in professional written and verbal communication skills.
• Competency in the use of a computer, including performing internet research and Microsoft Office Suites applications
• Reasonable ability to enter data into database systems (i.e. Salesforce, EHR)
• Reasonable accommodations can be made to enable individuals with disabilities to perform the essential functions.
• Ability to work on a computer and see details of objects at close range.
• Ability to hear within normal range, and communicate effectively (in person, telephone or Zoom).
• Finger dexterity and the ability to use all standard office equipment.
• Sit or stand comfortably; and the ability to navigate throughout office spaces (via elevator or stairs).
• GLIDE’s buildings are located in the Tenderloin neighborhood.  GLIDE maintains an "open door" policy to the community and its clients, who frequently enter and leave the building.
• This role is covered by the collective bargaining agreement.