Community Transition Case Manager

Help someone rebuild their life — one home visit at a time.

At Circle of Care St. Louis, you won’t manage numbers. You’ll support real people transitioning from nursing facilities into independent community living — and you’ll walk alongside them as they rebuild stability, dignity, and hope.

We are seeking a compassionate and motivated Community Transition Case Manager who believes that everyone deserves the opportunity to live safely and independently in their own home. This 28-hour per week position offers meaningful, hands‑on work in the community, professional development, and the chance to make a lasting difference.

The Community Transition Case Manager supports individuals transitioning from Skilled Nursing Facilities into community-based living. This role focuses on stabilization, service coordination, housing support, and ongoing monitoring to ensure long-term success in the community.

This position is structured to provide high-quality, person-centered case management through consistent engagement, proactive coordination, and strong advocacy.

This is a 28-hour per week position. The Case Manager must be available during standard business hours (9:00 a.m. – 5:00 p.m., Monday–Friday). The weekly schedule will be arranged with the Program Director within these hours. Flexibility is required to meet participant needs during business hours.

Conduct in-home visits following discharge from Skilled Nursing Facilities. Monitor health, safety, and housing stability. Ensure access to medications, medical appointments, food, and essential services. Identify risks early and intervene to prevent crises.

Develop and maintain person-centered service plans. Coordinate with home health providers, physicians, behavioral health professionals, housing providers, and community agencies. Assist individuals with navigating Medicaid, Medicare, Social Security, SNAP, and other public benefits.

Assess housing safety and accessibility. Support participants in maintaining stable housing. Advocate on behalf of participants with service providers and landlords. Encourage independence and community engagement.

Develop individualized emergency plans. Respond promptly to urgent issues impacting health or housing stability. Follow mandatory reporting requirements for suspected abuse, neglect, or exploitation.

Maintain timely and accurate case documentation. Record home visits, service coordination efforts, and participant progress. Participate in internal reporting and quality improvement efforts.

Associate’s degree required (Human Services, Social Work, Psychology, or related field preferred). Bachelor’s degree welcomed but not required. Minimum 1–2 years experience in case management, community-based services, healthcare coordination, or housing support preferred. Strong organizational and documentation skills. Ability to work independently in community settings. Valid driver’s license and reliable transportation.

• Starting pay: $23–$24 per hour, based on experience.
• Mileage reimbursement for approved work-related travel.
• Health Insurance Marketplace navigation support.
• Ongoing training and professional development. Supportive, mission-driven work environment.

Meaningful, relationship-centered work. Direct impact on individuals rebuilding their independence. Professional development and mentorship. A small organization where your voice matters. Leadership that values compassion, accountability, and growth.