CHC Nursing Facility Service Coordinator - Hybrid

UPMC; Northern (KY); Hybrid; USD 60,000 - 80,000; Full time

Job summary

UPMC Health Plan is seeking a full-time CHC Service Coordinator, Nursing Facilities to support Community HealthChoices across Lackawanna and Luzerne counties. The role requires significant travel (50%) to nursing facilities, with daytime hours Monday through Friday in a hybrid capacity.

The position centers on coordinating medical, behavioral, and social services for vulnerable residents, guiding PCSPs, and ensuring LTSS eligibility and quality care in nursing facilities.

Responsibilities

• Establish and build strong relationships with internal team members and partners to provide a collaborative environment.
• Educate on and coordinate community resources with emphasis on medical, behavioral, and social services.
• Manage an active caseload based on state mandated ratios according to residential setting, case intensity, and acuity.
• Collect program data to track participant progress monthly to ensure OPS reporting per regulatory deadline and compliance.
• Perform profession-level administrative duties involving research, analysis, and reporting.
• Prepare reports regarding service provision and update service plans per governing bodies.
• Ensure comprehensive assessments are completed within required time frames and evaluate care options, including benefits and community resources.
• Lead the Person-Centered Service Planning (PCSP) process and oversee PCSP implementation.
• Assist members in obtaining services to support living in nursing facilities.
• Identify, coordinate, and assist members in gaining access to LTSS and Medical Assistance services, as well as non-Medicaid funded services.
• Provide information to members and facilitate LTSS access and monitoring.
• Inform members about LTSS options, required assessments, PCSP process, service alternatives, and delivery options (including self-direction, rights, DHS Fair Hearing rights, risks, responsibilities).
• Assist with fair hearing requests when needed and requested.
• Collect information (preferences, strengths, goals) to inform PCSP development and reevaluate level of care annually or as needed.
• Assist the member and PCPT in selecting Providers and ensuring LTSS eligibility.

Job description

UPMC Health Plan is seeking a full-time CHC Service Coordinator, Nursing Facilities to support Community HealthChoices across Lackawanna and Luzerne counties. The role requires significant travel (50%) to nursing facilities, with daytime hours Monday through Friday in a hybrid capacity.

The position centers on coordinating medical, behavioral, and social services for vulnerable residents, guiding PCSPs, and ensuring LTSS eligibility and quality care in nursing facilities.