CHC Service Coordinator (Case Management, Social Work)- Erie, PA (Hybrid)

UPMC • Erie, PA

16h • Hybrid

About The Position

UPMC Health Plan is hiring Service Coordinators for its Community HealthChoices (CHC) team in Erie, Pennsylvania. CHC is Pennsylvania’s managed care program for long-term services and supports (LTSS), serving seniors and people with physical disabilities who are covered by Medicare and Medicaid.

The Service Coordinator provides community-based coordination across the continuum of care to help 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, drawing on communication and available resources to promote quality, cost-effective outcomes.

This is a hybrid position involving daily travel in the community, with field work required at least 75% of the time. The coordinator must also be able to work independently in a virtual setting.

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 connection with a minimum speed of 20 Mb/s download, 5 Mb/s upload, less than 50 ms ping, and under 10 ms jitter.
• Automotive insurance, driver’s license, and Act 34 clearance.
• Ability and willingness 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 service 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 support collaboration.
• Educate members about and coordinate access to 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.
• Perform administrative duties involving research, analysis, and reporting; prepare service-provision reports and update service plans in accordance with governing-body requirements.
• Ensure comprehensive assessments are completed within required time frames and assess care options using knowledge of 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 members with information about available LTSS, required assessments, person-centered planning, service alternatives and delivery options, self-direction, roles, rights, risks, and responsibilities.
• Assist with fair hearing requests when needed and requested, and help protect members’ health, welfare, and quality of life on an ongoing basis.
• Collect information about member preferences, strengths, and goals to inform PCSP development.
• Reevaluate members’ level of care annually or more frequently as needed.
• Assist members and their Person-Centered Planning Team (PCPT) 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 other community resources.
• Coordinate with individuals and entities involved in members’ physical and behavioral care to support seamless coordination among physical, behavioral, and support services.
• Ensure day-to-day compliance with state and federal regulations and guidelines, maintain confidentiality, and follow HIPAA requirements.

What This Job Offers

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