Service Coordinator (Social Work, Psychology)- Allegheny County (Hybrid)

UPMC•Pittsburgh, PA

4d•Hybrid

About The Position

UPMC Health Plan is hiring Service Coordinators for its Community HealthChoices (CHC) team in Allegheny County. CHC is Pennsylvania’s managed care long-term services and supports (LTSS) program for seniors and people with physical disabilities covered by Medicare and Medicaid. This hybrid position requires daily travel into the community, with field work at least 75% of the time, as well as the ability to work independently in a virtual setting. The Service Coordinator provides community-based coordination across the continuum of care to improve Members’ health outcomes. The role uses a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options and services that address individual health needs, using communication and available resources to promote quality, cost-effective outcomes. The position supports Members with complex medical, behavioral, and social needs and helps them remain safely and independently in their homes and communities.

Requirements

Bachelor’s degree in social work, psychology, or a related field with practicum experience preferred, or at least three years of experience in a social-service or healthcare-related setting.
Cultural competency and sensitivity to diverse backgrounds, including the ability to set aside personal opinions and implicit biases.
Valid driver’s license.
Reliable transportation.
Private workspace free from distractions.
Ability to meet strict regulatory deadlines and protect confidentiality in accordance with HIPAA guidelines.
Internet speed of at least 20 Mb/s download and 5 Mb/s upload, less than 50 ms ping, and under 10 ms jitter.

Nice To Haves

Experience working with people with disabilities or seniors in need of LTSS.
Knowledge of the home- and community-based services system and how to access and arrange services.
At least one year of LTSS, service coordination, or case management experience.
Background in case management and care coordination, including experience conducting in-home assessments and visits.
Experience working effectively with adults with complex medical, behavioral, and social needs.

Responsibilities

Build strong relationships with internal team members and partner providers to foster collaboration.
Educate Members about and coordinate community resources, including medical, behavioral, and social services.
Manage an active caseload according to state-mandated ratios based on residential setting, case intensity, and acuity.
Collect monthly program data to track participant progress and complete OPS reporting within regulatory deadlines and compliance requirements.
Perform profession-level administrative duties involving research, analysis, and reporting; prepare service-provision reports and update service plans in accordance with governing bodies.
Ensure comprehensive assessments are completed within required time frames and assess care options, including benefits and community resources.
Lead the Person-Centered Service Planning (PCSP) process and oversee implementation of PCSPs.
Assist Members in obtaining Home and Community-Based Services (HCBS) that support independent living.
Identify, coordinate, and help Members access LTSS, Medical Assistance services, and non-Medicaid-funded medical, social, housing, educational, and other services and supports.
Provide information to Members and facilitate access to, coordination of, and monitoring of their LTSS needs.
Inform Members about available LTSS, required assessments, the person-centered service-planning process, service alternatives and delivery options, including self-direction opportunities, roles, rights, risks, and responsibilities; assist with requested fair-hearing requests when needed.
Protect Members’ health, welfare, and quality of life on an ongoing basis.
Collect information about Member preferences, strengths, and goals to inform PCSP development.
Conduct annual level-of-care reevaluations, or more frequently as needed.
Assist Members and their Person-Centered Planning Teams (PCPTs) in identifying and choosing willing and qualified providers.
Work with Members to complete activities necessary to maintain LTSS eligibility.
Explore coverage for Member-identified needs through Medical Assistance, Medicare, private insurance, and community resources.
Coordinate actively with individuals and entities involved in Members’ physical and behavioral care to support seamless coordination of physical, behavioral, and support services.
Comply with state and federal regulations and guidelines in daily work, maintain confidentiality, and adhere to HIPAA requirements.
Work in the field at least 75% of the time and work independently in a virtual setting.