Field-Based Care Manager Associate (Hybrid/Remote)

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 52,000 - 70,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

Dental insurance

Disability insurance

401(k)

Paid Time Off

Job summary

UPMC Health Plan is seeking a Care Manager Associate to support members transitioning home after hospital or skilled nursing stays. You will work with a multidisciplinary team to address medical, behavioral health, and social determinants affecting health and well-being.

This role offers daytime hours in a hybrid structure with travel 50-75% across Allegheny and Westmoreland Counties; after orientation, remote work is possible when not in the community.

Responsibilities

• Review Health Plan data for services the member has received and identify gaps in care based on clinical standards of care.
• Assist clinical team with scheduling transportation, scheduling appointments, and tracking utilization.
• Refer members to appropriate case management, health management, or lifestyle programs based on assessment data.
• Assist members with non-medical needs that affect health and access to care.
• Successfully engage member in developing an individualized plan of care in collaboration with the member’s care team.
• Document all activities in the Health Plan’s care management tracking system following Health Plan standards based on information obtained from interaction with members and providers.
• Recognize and demonstrate shared accountability in development of a care plan with the member/caregiver as well as the team members to ensure optimal outcomes.
• Advocate on behalf of patient/family/caregivers for services access and for the protection of the patient’s health, wellbeing, safety and rights.
• Maintain an understanding of all health benefits and remains current on covered or in-plan services, benefit limitations, exclusions, and health management policies and procedures.
• Interfaces with and refers members to community-based resources and other supportive services as appropriate.
• Performs in accordance with system-wide competencies/behaviors.
• Performs other duties as assigned.

Job description

UPMC Health Plan is seeking a Care Manager Associate to support members transitioning home after hospital or skilled nursing stays. You will work with a multidisciplinary team to address medical, behavioral health, and social determinants affecting health and well-being.

This role offers daytime hours in a hybrid structure with travel 50-75% across Allegheny and Westmoreland Counties; after orientation, remote work is possible when not in the community.