Care Coordinator

Job Title: Care Coordinator

Reports To: Associate VP of Shelter Programs
FLSA Status: Full-time, Non-exempt

The Care Coordinator is a role responsible for supporting clients through the development of person-centered service plans, completing intake assessments, maintaining client files, and assisting with basic care coordination activities. This position ensures clients receive consistent communication, clear next steps, and linkage to community resources while progressing toward permanent housing goals.

Essential Duties and Responsibilities

Resident Engagement & Person-Centered Planning

• Assist residents in developing a person-centered plan based on their individual needs, preferences, and strengths.
• Discuss permanent housing goals upon admission and ensure these are incorporated into the resident's service plan.
• Conduct intake assessments, gather required documentation, and establish initial contact with internal and external providers.
• Maintain complete, organized, and up-to-date resident files in alignment with program, county, and contractual requirements.

Care Coordination & Follow-Up Support

• Act as the primary communication point for case managers, residents, and internal team members regarding basic coordination needs.
• Maintain regular individual contact with residents to monitor goal progress, identify barriers, and encourage engagement in services.
• Support residents with follow-through on action steps, including connecting to benefits, medical care, mental health services, employment supports, or housing resources.
• For individuals without an assigned community case manager, provide basic care coordination and assist in securing appropriate ongoing services.

Collaboration & Communication

• Attend and contribute to Utilization Review meetings, resident case discussions, and team meetings with Milwaukee County Housing Services and Adult Protective Services.
• Organize resident meetings to facilitate communication, strengthen engagement, and help identify program or individual needs.
• When concerns arise that cannot be resolved directly, notify Milwaukee County Housing Services and/or Adult Protective Services to determine next steps.

Documentation & Compliance

• Complete case notes, assessments, service plans, and follow-up documentation in a timely, clear, and professional manner.
• Maintain required documentation in accordance with agency policies, county guidelines, funder expectations, and confidentiality requirements.
• Track resident contacts, progress, incidents, and referrals accurately.

Program & Team Support

• Support Care Specialists and program leadership with communication follow-up, resource coordination, and resident engagement activities.
• Participate in required trainings, supervision, team meetings, and quality improvement initiatives.
• Perform other duties as assigned to ensure smooth program operations.

Qualifications

Required

• High School Diploma or GED (County minimum).
• At least 2 years of experience working with individuals experiencing mental illness, substance use challenges, and/or homelessness.
• Strong interpersonal and communication skills, with the ability to build rapport and maintain professional boundaries.
• Ability to maintain organized, detailed documentation and manage multiple follow-up tasks.
• Demonstrated cultural competence and ability to work respectfully with individuals from diverse backgrounds.

Preferred

• Associate or Bachelor's degree in Social Work, Psychology, Human Services, or related field.
• Experience in shelter, housing, or community-based human services.
• Familiarity with trauma-informed care, Housing First principles, motivational interviewing, or supportive services frameworks.
• Experience with case management or electronic documentation systems (e.g., Clarity, Mission Tracker).
• CPR/First Aid and Crisis Prevention & Intervention training.

Competencies

• Communication: Communicates clearly and professionally; maintains accurate documentation and keeps supervisors informed.
• Resident Engagement: Builds rapport, listens actively, and supports residents through a strengths-based and person-centered approach.
• Organization & Attention to Detail: Maintains thorough and accurate records; manages multiple follow-up tasks and deadlines effectively.
• Problem-Solving: Identifies issues early and seeks appropriate guidance; escalates concerns when they exceed the scope of the role.
• Collaboration: Works effectively with internal teams, community partners, and county agencies.
• Adaptability: Responds constructively to shifting resident needs, program demands, and county expectations.
• Professionalism: Consistently models ethical behavior, reliability, confidentiality, and respect.

Work Environment

This job description outlines the general nature and essential functions of the role and is not an exhaustive list of all responsibilities. Work is performed in a homeless shelter environment, which can be fast-paced and unpredictable. Staff may encounter:

• Individuals experiencing medical, behavioral, substance-use–related, or mental health crises
• Exposure to bodily fluids, infectious diseases, and other biohazards consistent with congregate care settings
• The presence of pests (such as bed bugs, lice, or rodents) due to the nature of emergency and transitional housing
• Fluctuating noise or activity levels and occasional disruptive behaviors
• Indoor and outdoor environments, including varying temperatures during support tasks

Essential functions may require standing or walking for extended periods; moving throughout multiple buildings; assisting with client needs; and lifting, pushing, or pulling up to 25 pounds. Additional safety procedures and personal protective equipment (PPE) may be required based on situational risk.

The physical and environmental demands described are representative of those necessary to perform the essential functions of the position. In accordance with the Americans with Disabilities Act (ADA), reasonable accommodations will be considered for qualified individuals with disabilities, provided such accommodations do not remove essential job duties or impose an undue hardship on the organization.