Transportation Care Manager/ Community Systems Navigator at Diverse Mosaic Community Center Inc

Transportation Care Manager / Community Systems Navigator

Diverse Mosaic Community Center (DMCC)

Location: Rochester, NY (In-Office with Community Engagement)

Pay: $22–$27 per hour based on experience

Schedule: Full-time or Part-time

Position Summary

Diverse Mosaic Community Center (DMCC) is seeking a compassionate, organized, and community-centered Transportation Care Manager / Community Systems Navigator to support families and individuals who face barriers accessing essential services due to transportation challenges.

This role supports Enhanced Care Management (ECM) and Health-Related Social Needs (HRSN) services under New York State’s 1115 Waiver Social Care Network initiative, ensuring Medicaid members can reliably access medical appointments, housing services, court proceedings, school meetings, behavioral health services, and other critical resources.

Transportation barriers are one of the leading reasons individuals miss care and fall deeper into crisis. The Transportation Care Manager will help bridge that gap by coordinating transportation services, providing direct transport when appropriate, and supporting individuals through complex systems navigation.

This position is ideal for someone committed to trauma-informed care, peer support models, and community-driven solutions.

Key Responsibilities

• Conduct screenings and eligibility assessments for Medicaid members receiving ECM and HRSN services

• Coordinate and arrange transportation for medical appointments, behavioral health services, court dates, school meetings, housing appointments, and other essential services

• Provide direct transportation support to clients when appropriate using a personal vehicle

• Develop and maintain individualized Social Care Plans that address transportation and other social care needs

• Coordinate services including housing support, transportation, food access, utilities, healthcare, and behavioral health services

• Provide follow-up care management contacts and ongoing case support

• Support individuals navigating systems such as healthcare providers, housing agencies, DSS, schools, and courts when appropriate

• Maintain accurate and timely documentation in compliance with Medicaid, Social Care Network, and ECM reporting guidelines

• Collaborate with community partners including healthcare providers, transportation providers, social services, housing agencies, and advocacy organizations

• Participate in team meetings, supervision, and case review sessions

• Maintain strict confidentiality and compliance with HIPAA standards

Qualifications

Required

• Bachelor’s degree in Social Work, Psychology, Human Services, Public Health, or related field OR equivalent experience in community advocacy, peer support, or care coordination

• Valid New York State driver’s license

• Reliable personal vehicle

• Active auto insurance meeting New York State requirements

• Ability to safely transport clients when appropriate

• Strong organizational and documentation skills

• Ability to work independently and collaboratively within a team

Preferred

• Experience with Medicaid care management, Health Homes, or Social Care Networks

• Experience supporting individuals facing housing instability, domestic violence, poverty, or behavioral health challenges

• Knowledge of New York State 1115 Waiver, Enhanced Care Management (ECM), or Health-Related Social Needs (HRSN) services

• BSW, BA/BS in related field, NY Certified Peer Specialist (NYCPS), or lived experience working in peer support or community advocacy

• Experience coordinating transportation services or community outreach

Compensation

• $22–$27 per hour (based on experience and driving record)

• Mileage reimbursement for client transportation

• Personal vehicle stipend available

• Full-time or part-time opportunities available

• Professional supervision and training provided

• Opportunities for professional growth within a mission-driven organization

Work Environment

This position includes a combination of:

• In-office work at DMCC in Rochester, NY

• Community-based visits with clients

• Transportation coordination and client accompaniment

• Collaboration with partner organizations

• Documentation and case management

About Diverse Mosaic Community Center

Diverse Mosaic Community Center is a peer-led, trauma-informed nonprofit organization dedicated to supporting families impacted by poverty, domestic violence, and system involvement such as CPS and family court.

Through advocacy, healing-centered programming, and wraparound services, DMCC works to strengthen families, uplift lived experience experts, and build healthier communities.

Our work centers dignity, empowerment, and community leadership in creating pathways toward stability and long-term well-being.