Mobile Professional Care Manager - Bedford & Blair Counties

UPMC•Pittsburgh, PA

7d•Hybrid

About The Position

UPMC Community Care Behavioral Health is seeking a full-time Mobile Professional Care Manager to support the Care Management Department in Bedford and Blair Counties. The role has flexible hours Monday through Friday and requires travel throughout both counties to meet members in the community. It is primarily community-based, with most time spent traveling and the remainder of work completed remotely or from home. The Mobile Professional Care Manager assists UPMC Health Plan members who need care coordination and conducts assessments of behavioral, clinical, social, and environmental needs. Members are followed in their communities, places of residence, and facilities. The position coordinates programs and services and facilitates communication among members, physicians, physical and behavioral health clinicians, and community-based services. The role requires Pennsylvania licensure in a health or human services field and a master's degree, or licensure as an RN (BSN preferred), or Paramedic/EMT qualifications with 6–8 years of experience. Three years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management is required. Additional preferred experience and qualifications are listed below. Required clearances, licenses, certifications, insurance, and CPR/BLS credentials are also specified.

Requirements

Pennsylvania licensure in a health or human services field and a master's degree, or RN licensure (BSN preferred), or Paramedic/EMT qualification with 6–8 years of experience.
Three years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management.
Detail orientation and excellent organizational skills.
Strong oral and written communication skills.
Ability to learn new software applications.
Act 33 Child Clearance with renewal.
Act 34 Criminal Clearance with renewal.
Act 73 FBI Clearance.
Automotive insurance.
Basic Life Support or Cardiopulmonary Resuscitation; CPR must meet AHA standards, include didactic and skills-demonstration components, and be completed within 30 days of hire.
Driver's license.
Required clinical social work, licensed social worker, professional counselor, licensed mental/behavioral health professional RN, or RN license.
Current licensure in the state where the facility is located, or, where applicable, a multistate license issued by a participating Nursing Licensure Compact state. Employees working on an out-of-state NLC license who move their residency to the facility's state must apply for licensure in that state within 60 days.

Nice To Haves

Five years of experience with community-based case management and behavioral health experience.
General knowledge of best practices for working with special-needs populations in the public sector.
Proficiency in Microsoft Office products.
Three years of experience in a managed care environment.
Experience with the geriatric population.
Certification in substance use disorders is helpful.
BSN preferred for RN candidates.

Responsibilities

Conduct face-to-face assessments by visiting members in their communities, residences, or facilities.
Coordinate on-site hospital discharge planning with facility staff when needed.
Coordinate with members’ physicians to support follow-up and continuity of care.
Collaborate with providers and others to obtain initial assessments, treatment planning, and aftercare planning for members.
Assess members’ behavioral, clinical, social, and environmental concerns and needs.
Facilitate linkages for members and families among primary care and behavioral health providers, social services, and other provider agencies to develop and coordinate service plans.
Ensure cases are managed and documentation is completed within established timeframes and departmental standards.
Participate in case conferences, interagency and provider treatment planning, and departmental meetings.
Make referrals and provide expertise regarding community and governmental agencies.
Assess members’ understanding of their clinical conditions and need for further education.
Implement clinical interventions to support optimal clinical and quality outcomes.
Develop outreach plans for assigned members who do not maintain recommended contact with medical or behavioral health providers and whose circumstances may contribute to frequent crises, recidivism, or reduced benefit from available care.
Receive and respond to complex and crisis calls.
Coordinate care and services across the continuum with case management, physicians, pharmacy, behavioral health, other providers, and health plan departments as appropriate.
Identify barriers to care and develop integrated plans of care with members, families, providers, and UPMC Health Plan staff.
Maintain contact with members and refer them to community-based case management services as appropriate.
Identify provider issues and recommend improvements.
Demonstrate knowledge of clinical treatment, case management, and community resources.