Field-Based CHC Service Coordinator — Hybrid Role

UPMC; Pittsburgh (Allegheny County); Híbrido; USD 42.000 - 58.000; Jornada completa

Descripción de la vacante

UPMC Health Plan is seeking Service Coordinators for the Community HealthChoices program in the Lehigh Valley. This hybrid role requires daily community travel to coordinate LTSS and HCBS services, assess member needs, and guide care planning to promote health outcomes.

As part of a collaborative team, you will manage caseloads, prepare reports, and support members in accessing Medicaid/Medicare benefits and community resources while ensuring compliance with regulations and privacy standards.

Responsabilidades

• Establish and build strong relationships with internal team and partner providers to foster a collaborative environment; educate on and coordinate community resources.
• Manage an active caseload per state ratios; collect program data and track participant progress monthly; ensure OPS reporting meets regulatory deadlines.
• Perform professional administrative duties including research, analysis, and reporting; update service plans per governing bodies; ensure timely assessments and assess care options using benefits and community resources.
• Lead the PCSP process and oversee PCSP implementation; assist Members in obtaining HCBS services to support independent living.
• Identify, coordinate, and assist Members in gaining access to LTSS, Medical Assistance, and other services; provide information and coordinate LTSS needs.
• Inform Members about LTSS, required assessments, PCSP, service options including self-direction, DHS Fair Hearing rights, and assist with fair hearings when needed.
• Collect information such as Member preferences, strengths, and goals to inform PCSP; reevaluate level of care; assist in identifying providers.
• Work with Members to maintain LTSS eligibility; explore coverage through MA, Medicare, private insurance, and other community resources.
• Coordinate with professionals to ensure seamless physical, behavioral, and support services; ensure compliance with state/federal regulations and HIPAA.
• Willingness to perform fieldwork 75% of the time and to work independently in a virtual setting.

Descripción del empleo

UPMC Health Plan is seeking Service Coordinators for the Community HealthChoices program in the Lehigh Valley. This hybrid role requires daily community travel to coordinate LTSS and HCBS services, assess member needs, and guide care planning to promote health outcomes.

As part of a collaborative team, you will manage caseloads, prepare reports, and support members in accessing Medicaid/Medicare benefits and community resources while ensuring compliance with regulations and privacy standards.