Community Healthlink

Case Manager- Homeless Outreach and Advocacy Project Medical

# Positions
Experience (Years)
Homeless Services and Inpatient Substance Abuse Recovery - Case Management


HOAP - Homeless Outreach & Advocacy Project:  Many years ago Community Healthlink recognized that so many of the homeless in our society also battle mental illness, and often a substance abuse problem. In 1985, the Homeless Outreach & Advocacy Project was established with a commitment to link the region’s homeless to a complement of services that would offer: Screenings, assessments, counseling, health care, rehabilitation, and referral to other support systems. 


In addition, a physician and registered nurses and nurse practitioners perform medical evaluations at HOAP’s primary care clinic, 72 Jaques Ave., Worcester. They visit area shelters to evaluate and refer people for treatment. A psychiatrist and a team of licensed clinicians perform mental health screenings and offer counseling and medications. Case Management staff helps clients to enroll in available health insurance programs, access health care and social security benefits, and resolves other benefits-related issues.

Outreach performed by HOAP staff is done in the community, through a variety of shelters and other emergency care programs. Staff also seeks to establish contact with the homeless at vacant lots, and even along railroad tracks and bridges. Basic services are also available at HOAP’s primary care clinic and staff offices.


HOAP also offers services in partnership with other local health care providers such as the Great Brook Valley Health Center and Family Health Center in Worcester.


In addition to its counseling and support services, staff helps manage scattered-site housing in the Worcester area for unaccompanied homeless adults and at-risk families including:


Supportive Housing HIV, Homelink, Shelter + Care, Rental Assistance HIV, and Leasing Assistance/CSPECH


  • Perform comprehensive case management intake and assessment of the supportive service, clinical, recovery resources, emergency shelter and/or housing needs of homeless adults.
  • Develop appropriate service plans in conjunction with clients for the delivery of essential services.
  • Assist program manager with screening for behavioral health and MAT assessment intakes.
  • Complete initial behavioral health and addiction intake registration paperwork, including release forms.
  • Work collaboratively with HOAP integrated team to coordinate the delivery of appropriate clinical, addiction and other support services, including coordinating meet and greets between client and clinical staff.
  • Communicate with referral source or case manager of client attendance to intakes or appointments to improve attendance rate and address no shows.
  • Make appropriate referrals to existing community agencies for additional supportive or housing services as needed within the Worcester community.
  • Provide ongoing case management services to assist clients with obtaining various entitlements and benefits (i.e., SSI, EAEDC, MassHealth and other health insurance needs, addiction services and other community resources)
  • Make referrals and assist clients with applications for subsidized housing, private mainstream housing, sober housing or other housing resources.
  • Provide transportation assistance to individuals as needed. Assist clients in accessing transportation through their health insurance and/or budgeting.
  • Perform outreach services in conjunction with the clinical team or other staff.
  • Co-facilitate groups and provide necessary preparation and group planning support
  • Identify gaps in homeless services and provide data for the purpose of client advocacy.
  • Assist program manager with tracking of ongoing programmatic data management.
  • Participate in collaborative case conferences regarding service planning for homeless adults.
  • Attend weekly HOAP Staff meetings, Clinical team, OBAT/MAT team, behavioral health team meetings, supervision and all other required program meetings.
  • Prepare and maintain confidential client documentation, service records, staff activity logs (SALS) and preparation of statistical reports.
  • Assist with checking client’s insurance and any insurance related issue. Help clients with prescription problems – contacting insurance company for overrides to make sure clients have their medications.
  • Attend or participate in relevant trainings.
  • Perform all other duties as required.



  • Grade 6: Case Manager II: Bachelor's degree required; degree in human services, psychology, social work or related field preferred
  • 3 years experience working with homeless individuals
  • Current valid US-issued drivers license and ability to provide registered, inspected and insured automobile for work related purposes including transporting clients in your own vehicle
  • Must be able to pass a CORI background check

Community Healthlink is an Affirmative Action/ Equal Opportunity Employer. We do not discriminate in employment and personnel practices on the basis of race, sex, gender identity, age, ancestry, disability, religion, national origin, marital status, sexual preference, political affiliation or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above listed items.
If applicable, Community Healthlink shall also abide by the requirements of 41 CFR 60-300.5(a) and 41 CFR 60-741.5(a). These regulations prohibit discrimination against qualified protected veterans and qualified individuals on the basis of disability. These regulations require affirmative action by Community Healthlink to employ and advance in employment qualified protected veterans and individuals with disabilities.


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