Care Manager​/Community Systems Navigator

Care Manager / Community Systems Navigator

Diverse Mosaic Community Center (DMCC)

Location:

Rochester, NY (In-Office with Community Engagement)

Pay: $24–$29 per hour based on experience

Schedule:

Full-time or Part-time

Diverse Mosaic Community Center (DMCC) is seeking a compassionate, organized, and community-centered Care Manager / Community Systems Navigator to support families and individuals navigating complex systems such as healthcare, housing, behavioral health, and child welfare.

This role supports Enhanced Care Management (ECM) and Health-Related Social Needs (HRSN) services under New York State’s 1115 Waiver Social Care Network initiative, helping Medicaid members access critical resources and stabilize their health and living conditions.

The Care Manager will work closely with individuals and families experiencing challenges such as housing instability, poverty, domestic violence, CPS involvement, or behavioral health needs. This position is ideal for someone committed to trauma-informed care, peer support models, and community-driven solutions.

• Conduct screenings and eligibility assessments for Medicaid members receiving ECM and HRSN services
• Complete Enhanced Care Management documentation and required reporting
• Develop and maintain individualized Social Care Plans based on client needs and goals
• Coordinate services including housing support, transportation, food access, utilities, healthcare, and behavioral health services
• Provide follow-up care management contacts and ongoing case support
• Support individuals navigating systems such as healthcare providers, housing agencies, DSS, schools, and courts when appropriate
• Maintain accurate and timely documentation in compliance with Medicaid and Social Care Network guidelines
• Collaborate with community partners including healthcare providers, social services, housing agencies, and advocacy organizations
• Participate in team meetings, supervision, and case review sessions
• Maintain strict confidentiality and compliance with HIPAA standards

• Bachelor’s degree in Social Work, Psychology, Human Services, Public Health, or related field OR equivalent experience in community advocacy or care coordination
• Strong organizational and documentation skills
• Ability to work independently and collaboratively within a team
• Valid driver’s license and reliable transportation for community visits

• Experience with Medicaid care management, Health Homes, or social care coordination
• Experience supporting individuals facing housing instability, domestic violence, poverty, or behavioral health challenges
• Knowledge of New York State 1115 Waiver, Social Care Networks, or Enhanced Care Management services
• BSW, BA/BS in related field, NY Certified Peer Specialist (NYCPS), or lived experience working in peer support or community advocacy

• $24–$29 per hour (based on experience)
• Full-time or part-time opportunities available
• Professional supervision and training provided
• Opportunities to grow within a mission-driven organization

• In-office work at DMCC in Rochester, NY
• Community-based visits with clients
• Coordination with partner organizations
• Documentation and case management

Diverse Mosaic Community Center is a peer-led, trauma-informed nonprofit organization dedicated to supporting families impacted by poverty, domestic violence, and system involvement such as CPS and family court.

Through advocacy, healing-centered programming, and wraparound services, DMCC works to strengthen families, uplift lived experience experts, and build healthier communities.

Our work centers dignity, empowerment, and community leadership in creating pathways toward stability and long-term well-being.