Care Manager

57 Willoughby St 2nd Fl
57 WILLOUGHBY STREET
2nd FLOOR
Brooklyn, NY 11201, USA

Compensation: $50,000-$52,000 annually commensurate with experience.

Spanish bilingual proficiency is preferred for this role. Candidates hired to support clients in Spanish are eligible for additional compensation.

A Care Manager at Housing Works holds a deeply rewarding, hands‑on role supporting individuals with complex medical, behavioral health, and social service needs. Care Managers are at the forefront of our mission, working directly with clients to help them navigate systems of care, overcome barriers, and achieve meaningful, client‑defined goals as part of a thriving and growing organization. This role offers the opportunity to develop strong clinical and engagement skills within a multidisciplinary team that includes medical providers, behavioral health professionals, supervisors, and community‑based partners.

While Care Managers maintain a level of professional autonomy, the work is rooted in accountability, responsiveness, and consistent, direct client contact as the foundation of effective care management. Care Managers serve as the primary point of contact for their assigned clients and are responsible for building trusting, sustained relationships through regular in‑person engagement. This includes meeting clients in their homes, communities, healthcare settings, and the office to conduct assessments, coordinate services, and support ongoing care planning.

To ensure high‑quality, person‑centered care, Care Managers are expected to maintain an active and consistent field and office presence. Meaningful face‑to‑face interaction with clients and service providers is an essential component of this role and is critical to fostering engagement, coordinating care, and achieving positive health outcomes. At Housing Works, we believe our staff are one of our greatest assets.

We demonstrate this commitment by offering a competitive salary, generous tuition reimbursement, and a robust benefits package, including opportunities for eligible team members to further their education and professional growth.

The Health Home Care Manager guides clients with chronic illness(es) through the health care system by assisting with access challenges, developing relationships with service providers, and tracking interventions and outcomes.

• Conduct comprehensive in-person initial assessments and annual reassessments of clients’ medical, mental health, substance use, financial, housing, and support needs in community, home, clinical, or office‑based settings.
• Develop and maintain individualized, patient‑centered plans of care with documented input and approval from clients and collaborating providers, updating care plans at least every 3–6 months or when new needs are identified, in accordance with Health Home standards.
• Collaborate closely with medical and behavioral health providers through face‑to‑face meetings and coordinated care activities to develop, implement, and monitor care plans for clients with chronic conditions such as diabetes, asthma, congestive heart failure, hypertension, behavioral health conditions, HIV, and other complex health needs.
• Engage clients in person to review housing options based on program eligibility and provide hands‑on assistance with housing‑related applications, including the 2010E (application submission and psychosocial completion), NYC Housing Connect, Section 8, and other relevant housing programs.
• Address benefits‑related needs through direct client support, including Medicaid, HRA, SNAP benefits, medical transportation, and other entitlement programs, utilizing in‑person advocacy and coordination when appropriate.
• Conduct regular home and field visits to maintain consistent client engagement, assess changing needs, and support progress toward care plan goals in accordance with Health Home program standards and client preferences.
• Coordinate client services with internal and external providers through regular, in‑person or hybrid case conferencing
  , occurring at least quarterly, to ensure alignment, accountability, and continuity of care.
• Document all in‑person and care…