Job Description

Job Description

Job Description

Department:  Community Outreach & Services (COS) 

Status:  Full-time, non-exempt 

Hours:  Monday–Friday | 8:30 AM – 5:00 PM

Compensation: $32.80 per hour  

Reports To:  Community Services Supervisor

About Us  

St. Mary’s Center is a community of hope, healing, and justice dedicated to serving older adults, preschool families, and individuals experiencing homelessness in Oakland and the surrounding Alameda County community. St. Mary’s Center operates transitional housing, a senior center, and preschool and is developing permanent supportive housing as part of a comprehensive, collaborative community development strategy along the San Pablo Avenue corridor. We are proud of an excellent multidisciplinary team delivering high-quality services through which St. Mary’s supports vulnerable populations in aging safely, independently, and with dignity. 

Community Services Program Overview  

The Community Outreach & Services (COS) Department helps seniors remain safely housed and socially connected while reducing isolation, improving wellness, and promoting access to community-based supports. COS programming includes congregate meals, wellness activities, fall prevention, computer education, health navigation, case management support, behavioral health education, and Friendly Visiting services. 

Position Summary  

The Community Services Case Manager provides comprehensive AAA-aligned case management services to older adults and adults with disabilities participating in St. Mary’s Center programs. This position supports individuals in maintaining independence, improving health and social outcomes, and remaining safely housed within the community through coordinated care planning, advocacy, benefits assistance, and connection to supportive services. 

The Case Manager maintains an active caseload of approximately 30 participants and delivers individualized, trauma-informed, culturally responsive services through assessments, home visits, office visits, phone outreach, care coordination, group support, and collaboration with community providers and multidisciplinary teams. 

This position also supports Medi-Cal Administrative Activities (MAA/CMAA) through eligible outreach, referral coordination, benefits navigation, health-related case management activities, and documentation that improves access to medical, behavioral health, and supportive services. 

Essential Duties & Responsibilities  

Case Management & Care Coordination  

• Maintain an active caseload of 30 seniors and adults with disabilities enrolled in AAA and Community Services programs. 

• Conduct comprehensive biopsychosocial assessments to identify participant strengths, risks, barriers, and service needs. 

• Develop, implement, monitor, and update individualized case plans. 

• Coordinate transportation, meals, medical and behavioral health services, medication support, shopping assistance, housing resources, IHSS, benefits advocacy, legal services, social activities, and other supports. 

• Assist participants with Medi-Cal, SSI, CalFresh, IHSS, and related applications and renewals. 

• Provide health-related care coordination and referrals. 

• Conduct home visits, wellness checks, and follow-up contacts. 

• Provide crisis intervention and de-escalation support within scope of practice. 

• Identify and report suspected elder abuse or neglect. 

• Support transitions to higher levels of care when appropriate. 

• Facilitate participant engagement in Community Center programming. 

Medi-Cal Administrative Activities (MAA/CMAA)  

• Conduct Medi-Cal outreach and education activities. 

• Assist participants in accessing medically necessary services. 

• Coordinate communication between providers, social services, and caregivers. 

• Maintain accurate documentation and reporting aligned with county and state requirements for eligible MAA/CMAA activities. 

• Participate in data collection and service tracking activities that support reimbursement and reporting efforts. 

Collaboration & Community Partnerships  

• Collaborate with Housing Services, Behavioral Health, Community Center staff, and leadership. 

• Partner with Alameda County agencies, hospitals, clinics, managed care plans, and community-based organizations. 

• Participate in interdisciplinary case conferencing and care coordination meetings. 

• Engage caregivers and family members when appropriate. 

• Represent St. Mary’s Center at community meetings and trainings. 

Documentation & Compliance  

• Maintain accurate and timely documentation in agency and County systems. 

• Complete assessments, progress notes, case plans, referrals, and discharge summaries. 

• Maintain compliance with HIPAA, state, county, city, and agency standards. 

• Track units of service, outcomes, and referrals. 

• Complete 20 hours of Community Health Worker training and 6 hours of continuing education annually. 

• Participate in required quality assurance activities and trainings. 

Program Operations & Community Engagement  

• Promote COS programs through outreach events, presentations, and community engagement activities. 

• Assist with congregate meal services, workshops, and cultural programming. 

• Participate in emergency preparedness and emergency response activities. 

• Collect participant feedback and support program evaluation efforts. 
  

Qualifications  

• Strong communication and interpersonal skills. 

• Ability to work effectively with older adults and vulnerable populations. 

• Knowledge of community resources, benefits systems, and supportive housing. 

• Familiarity with Medi-Cal, SSI, IHSS, and CalFresh. 

• Knowledge of trauma-informed care, motivational interviewing, and harm reduction. 

• Understanding of elder abuse prevention and mandated reporting. 

• Strong organizational and documentation skills. 

• Associate or bachelor's degree in human services, psychology, sociology or related field or three years’ experience in a related field. 

• Minimum of 2 years of experience working with older adults, vulnerable populations, or community-based programs preferred. 

• California Driver's License 

Work Environment  

This position operates in community-based settings including participant homes, senior housing sites, community centers, and partner organizations throughout Alameda County. 

General Staff Expectations  

• Promote a safe, respectful, and inclusive environment. 

• Support the mission and values of St. Mary’s Center. 

• Maintain professionalism and confidentiality. 

• Follow agency policies and procedures. 

Physical Requirements  

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  In general, while performing the duties of this job, the employee is expected to stand; walk; sit; reach with hands and arms; and talk or hear.    

• Ability to sit, stand, walk, bend, and communicate effectively throughout the workday. 

• Ability to travel to participant homes and community sites. 

• Ability to occasionally lift and/or move up to 20 pounds. 

• Ability to use computers, phones, tablets, and related technology for documentation and communication. 

Equal Employment Opportunity  

St. Mary’s Center is an equal opportunity employer and is committed to an active Equal Employment Opportunity. We celebrate diversity and are committed to an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, genetic information or veteran status.  

In compliance with the California Fair Chance Act, St. Mary’s Center will consider qualified applicant with a criminal history pursuant to the California Fair Chance Act. 

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