Care Manager Associate (Hybrid) - Contract

UPMC • Pittsburgh, PA

11d • Hybrid

About The Position

The Care Manager Associate supports UPMC Health Plan members in the community as they transition home after a hospital or skilled nursing stay. Working with an experienced, multidisciplinary clinical care management team, the Associate helps address medical, behavioral health, and social determinant of health needs that may affect members’ health and well-being. The role coordinates support services and resources to facilitate effective care plans and optimal member satisfaction and clinical and financial outcomes.

The Associate works collaboratively with the Community Services Team to develop an understanding of clinical care and utilization management, collect or assist with documentation for simple to moderately complex care management assignments, and provide administrative support to clinical staff. The position involves telephone and face-to-face contact with members, family members, and other stakeholders to support problem-solving, referrals, and access to community-based services and resources.

This is a hybrid, community-based contract role with daylight hours and approximately 50–75% travel to hospitals, provider sites, and member residences in Allegheny and Westmoreland Counties. Minimum weekend, after-hours, or holiday coverage may be needed. After successful completion of orientation and training, the role may be performed remotely when the Associate is not working in the community. The position is offered through Strategic Consulting Partners (SCP), whose employees work as contractors for UPMC.

Requirements

• Bachelor’s degree in social work, or an associate degree in another health or human services field that promotes the physical and psychosocial well-being of those served.
• Ability to interact professionally with other health care professionals.
• Excellent verbal and written communication and interpersonal skills.
• Act 34 clearance.
• Act 33 clearance.
• Act 73 clearance.
• Travel approximately 50–75% of the time to hospitals, provider sites, and member residences in Allegheny and Westmoreland Counties.

Nice To Haves

• Managed care experience.
• Computer efficiency.
• Knowledge of community resources.
• CPR certification.

Responsibilities

• Review Health Plan data on services members have received and identify gaps in care based on clinical standards.
• Assist the clinical team with transportation and appointment scheduling and utilization tracking.
• Refer members to appropriate case management, health management, or lifestyle programs based on assessment data.
• Assist members with non-medical needs that affect health and access to care.
• Engage members in developing individualized plans of care in collaboration with their care teams.
• Document activities in the Health Plan’s care management tracking system in accordance with Health Plan standards and information obtained from members and providers.
• Share accountability for developing care plans with members or caregivers and team members to support optimal outcomes.
• Advocate for patients, families, and caregivers regarding service access and protection of patients’ health, well-being, safety, and rights.
• Maintain an understanding of health benefits, covered or in-plan services, benefit limitations and exclusions, and health management policies and procedures.
• Connect members with community-based resources and other supportive services as appropriate.
• Perform in accordance with system-wide competencies and behaviors.
• Perform other duties as assigned.

Benefits

• Medical insurance
• Vision insurance
• Dental insurance
• Disability insurance
• 401(k)
• Paid time off, including 9 holidays, 2 floating holidays, and PTO accrual beginning on the first day of employment

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level