Who We Are:

Aliveness Project is a community center for people living with HIV. We serve over 5,000 folks annually, the majority of whom are low-income. The Aliveness Project boldly advances equitable access to transformative HIV care and prevention. Our primary objectives are to ensure that our members have access to:

Basic needs: We provide meals, a food shelf, and medical nutrition therapy while our Case Management team helps provide access to healthcare and housing.

Community:

Our community center model provides a safe and supportive place for members to gather and build community.

Prevention:

We provide a community-based free PrEP/STD Clinic, pharmacy, and targeted outreach to communities disproportionately affected by HIV through education, awareness, and strategies for eliminating stigma. Aliveness Project is an equal opportunity employer and is committed to building and maintaining a diverse staff that is representative of the communities we serve and live in. People of color, LGBTQ-identified individuals, and people with lived experiences are strongly encouraged to apply.

Position Title :

Transitional Case Manager Reports to:

Case Management Team Manager Job Summary:

The Transitional Case Manager provides short-term, intensive case management and support services for individuals living with HIV who are experiencing complex life circumstances. This position is responsible for assessing client needs, connecting clients to medical and social resources, and supporting engagement in long-term HIV care. The goal is to promote client stability, treatment adherence, and self-determination while ensuring compliance with Ryan White, and other program requirements.

Major tasks include:

Assessment & Planning

Develop individualized, strengths-based care plans focused on stabilization and transition to ongoing HIV care
Collaborate with clients to establish realistic, measurable goals that encourage independence Service Coordination
Connect clients to healthcare providers, housing programs, mental health and substance use treatment, insurance (Medicaid, ADAP), and other community support systems
Facilitate referrals internally/externally and track engagement across medical, behavioral, and social service networks
Work closely with community partners, internal Aliveness Project programs, and public health programs to support continuity of care
Acting as the point person for Case Management Walk-In hours, ensuring equity in access to Aliveness Services Monitoring & Follow-Up
Maintain regular contact with clients to monitor progress toward care plan goals and adherence to HIV treatment
Conduct follow-up assessments to adjust plans and address ongoing or emerging needs
Document contacts, progress, and outcomes consistently in accordance with funding and agency standards Client Advocacy
Advocate for clients within healthcare and social service systems to remove barriers to care
Provide education on HIV treatment, prevention, and self-management
Empower clients to build life skills and utilize available resources effectively Documentation & Compliance
Maintain timely, complete, and confidential electronic and paper case records
Ensure compliance with Ryan White, HOPWA, and other funding requirements
Participate in audits, trainings, and supervision as required Transitional Support
Provide assistance and triage needs of clients who are recently diagnosed, re-entering care, or who may be in crisis
Develop strategies linking clients to long-term services and primary care providers Other
Participate in staff meetings, regular supervision and organization wide efforts as requested
Other duties related to the role as assigned

Qualifications:

Bachelor's degree in Social Work, Human Services, or related field preferred (or equivalent work experience) Minimum 2 years of experience in case management, especially with HIV/AIDS, reentry, or housing programs Knowledge of community resources, government assistance, and HIV-related health systems (Ryan White, HOPWA, ADAP) Strong organizational, problem-solving, and interpersonal communication skills Ability to work independently and as part of a multidisciplinary team Cultural competency in working with diverse populations including justice-involved individuals, immigrants, people of color, LGBTQIA+ persons, and those experiencing homelessness or substance use challenges Fluency in Spanish preferred Commitment to Aliveness' mission of HIV education, prevention and destigmatization

Compensation:

Salary range is $50,000 to $52,000 based on experience.

Benefits:

Generous benefits include health insurance, holidays and Paid Time Off (PTO) and 4% employer matched IRA. Benefits include medical insurance, dental insurance, vision insurance, life insurance, long-term disability insurance and free lunch.

To Apply:

Submit your resume, a brief cover letter outlining your experience and interest in the position, and three references to macy@aliveness.org . 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