Exceptional People + Purpose Beyond Profit = Watershed Outcomes

Exceptional People + Purpose Beyond Profit = Watershed Outcomes

Community Resources Guide



Cleveland, OH, USA
Posted on Tuesday, January 9, 2024
firsthand is changing the way individuals living with Serious Mental Illness (SMI) get care – by putting them at the center of everything we do. Our peer led model aims to build trust with these individuals, many of whom have been underserved, stigmatized, deprioritized and have very often lost trust in the systems intended to serve them. Our holistic approach includes partnering with our team of peer recovery specialists, licensed social workers and nurse practitioners, and focuses on meeting them where they are and walking with them side by side, as a trusted guide, partner, and first call, on their journeys’ to wellness.
Our aim is to not only improve lives, but also improve the economics for managed care plans and states responsible for providing care to this community. This enables us to build solutions that scale and, as a result, change the way our society supports those most impacted by SMI.
We are building a team of deeply passionate problem-solvers who are courageous enough to take on one of the country’s most challenging healthcare problems. Those who are up for the task will be rewarded with deeply mission-oriented workdays, mentorship from a similarly motivated team, and a supportive culture that prioritizes learning, creativity, and fun.
The Community Resources Guide (CRG) is responsible for linking newly engaged individuals with serious mental illness to community-based supportive services in order to address social determinants of health and support their overall wellness. The CRG will do this by working with peer recovery specialists (firsthand Guides) to empower individuals to identify and achieve their own recovery goals. Supportive services may include rental/utility assistance, access to food or pantries, Social Security benefits, primary care, or community behavioral health services.
The CRG must be able to work in the community, meeting individuals where they are, and be comfortable working in non-traditional settings and unstructured environments. Experience assisting individuals with Social Security benefits enrollment, including SSI/SSDI Outreach, Access, and Recovery (SOAR) certification, is highly preferred.

As a Community Resources Guide, you will:

  • Perform social and behavioral health assessments to support individuals living with serious mental illness in identifying barriers to wellness.
  • Build personalized initial care plans to address social needs.
  • Link individuals to community-based resources and supportive services including SSA benefits, community programs, housing, food, etc.
  • Complete interviews with individuals, gather medical records, and other information to complete SSI/SSDI applications.
  • Engage in care coordination as part of a multidisciplinary team of peers, social workers, and clinicians to assist individuals in accessing appropriate services and support.
  • Assist in outreach and engagement efforts led by firsthand Guides, which may include visiting homes and communities, local homeless shelters and drop-in centers, hospitals, and emergency departments.
  • Address transportation barriers by assisting in accessing transportation benefits, navigating public transportation, and providing transportation as needed.
  • Provide direct assistance, when appropriate, when individuals are facing challenging situations, and triage to appropriate additional interventions.

You'll be a good fit if you have:

  • Empathy, compassion, and approachability
  • Excellent listening, communication, and interpersonal skills
  • Desire to help people in need and support their path to wellness
  • Comfortable doing community visit in individual’s homes and neighborhoods
  • Clinical knowledge, inclusive of SMI, substance use, and physical health conditions
  • Comfort working as part of a multidisciplinary team, and enjoy mixed roles and duties - this is a mix of direct service, teaching, and care management
  • Cultural humility, knowledge of trauma informed care, and social determinants of health
  • Familiarity with local resources and community programs
  • Strong organizational skills, attention to detail, and writing skills
  • Ability to prioritize multiple tasks and meet deadlines
  • Ability to maintain professional boundaries and engagement skills with a population with challenges and in non-traditional work conditions
  • Proficiency with Google Suite

The required experience you bring to this role includes:

  • Experience serving those with complex medical conditions, and preferably SMI and/or SUD
  • SSI/SSDI Outreach Access Recovery (SOAR) certification or willingness to get certified within 6 months of employment (firsthand will support certification process if needed)
  • Ability to operate a vehicle (company vehicle may be provided), including a driver’s license that is active and in good standing; must be eligible to drive under Company insurance policy

Preferred experience:

  • Bachelors or Masters Degree in social work, psychology, or related human services field
  • Lived experience with SMI and/or SUD
  • Prior experience performing direct in-person outreach and engaging individuals with SMI
  • Trained in motivational interviewing, recovery-oriented services, and trauma-informed care
firsthand Benefits:
For Full Time employees, our compensation package includes base, equity and a bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, flexible vacation, and a supportive culture.
We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to getting to know you.
Unfortunately, we are not able to offer sponsorship at this time.