About The Position
UPMC Health Plan is hiring Service Coordinators for its Community HealthChoices (CHC) team in Butler County. CHC is Pennsylvania’s managed care long-term services and supports (LTSS) program for seniors and individuals with physical disabilities who are covered by Medicare and Medicaid. This hybrid role 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 member health outcomes. The role uses a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate services and options that meet members’ health needs, using communication and available resources to promote quality, cost-effective outcomes. The coordinator supports adults with complex medical, behavioral, and social needs and helps participants remain safely and independently in their homes and communities.
Requirements
- Bachelor’s degree in social work, psychology, or another 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 connection with at least 20 Mb/s download, 5 Mb/s upload, less than 50 ms ping, and under 10 ms jitter.
- Willingness and ability to work in the field at least 75% of the time and independently in a virtual setting.
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.
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 program data monthly to track participant progress and complete OPS reporting by regulatory deadlines.
- Conduct research, analysis, reporting, and other profession-level administrative duties; prepare service-provision reports and update service plans in accordance with governing bodies.
- Complete comprehensive assessments within required time frames and assess care options, 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.
- Inform members about available LTSS, required assessments, the person-centered planning process, service alternatives and delivery options, self-direction opportunities, roles, rights, risks, and responsibilities; assist with requested fair-hearing requests.
- Gather member preferences, strengths, and goals to inform PCSP development.
- Reevaluate level of care annually or more frequently as needed.
- Help members and their Person-Centered Planning Team identify and choose willing and qualified providers.
- Work with members to complete activities necessary to maintain LTSS eligibility.
- Explore coverage for identified needs through Medical Assistance, Medicare, private insurance, and community resources.
- Coordinate 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, maintain confidentiality, and adhere to HIPAA requirements.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
