Social Care Network Navigator Screener

JOB SUMMARY

This position is responsible for screening, navigation, and referral services to individuals and families seeking support through our programs and social care network. Assesses client needs related to social determinants of health, coordinates access to appropriate services and ensures timely and accurate documentation of all client interactions. Plays a critical role in connecting participants with internal programs and external community partners to promote stability, well-being, and self-sufficiency.

RESPONSIBILITIES AND DUTIES

Primary Responsibilities:

• Conducts client intake and screening to assess needs related to housing, food access, employment, transportation, and other social determinants of health.
• Determines program eligibility and completes intake documentation in accordance with CAO and donor requirements.
• Develop individualized service and social care plans that include client goals, referrals, and follow-up actions.
• Coordinate and submit referrals to internal programs and external social care network partners.
• Track and manage referrals to ensure timely connection to services and successful outcomes.
• Maintain accurate and up-to-date client records in data management systems.
• Provide ongoing follow-up with clients to monitor progress, identify and address barriers, and update service plans as needed.
• Collaborate with internal departments and community partners to expand access to services and resources.
• Conduct outreach and engagement activities to identify and recruit eligible participants.
• Assist clients with navigating systems related to housing, benefits, healthcare, and other essential services.
• Support clients with applications, documentation, and coordination of services as needed.
• Ensure all case notes, documentation, and reporting requirements are completed accurately and within required timeframes.
• Participate in required meetings, trainings, and collaborative workgroups related to social care network initiatives.
• Maintain knowledge of available community resources and services in the Western New York area.
• Ensure compliance with all program guidelines, confidentiality standards, and data reporting requirements.
• Maintain compliance with federal, state, and CAO standards.

Secondary Responsibilities:

• Must present a professional image in conduct, attitude, and attire.
• Satisfactory completion of mandatory trainings.
• Additional duties as assigned.