Field-Based LTSS & Care Coordination Specialist

UPMC; Tobyhanna Township (PA); Hybrid; USD 42,000 - 65,000; Full time

Job summary

UPMC Health Plan is seeking Service Coordinators in Monroe Pike, PA area for the Community HealthChoices team. Hybrid position requiring daily community travel, serving seniors and individuals with disabilities under LTSS.

Responsibilities include managing caseloads, coordinating resources, and ensuring timely assessments and PCSP implementation to support independent living and access to LTSS and Medical Assistance.

Qualifications

• Strong background in case management and care coordination.
• Experience conducting in-home assessments and visits.
• Proven ability to work with adults with complex medical, behavioral, and social needs.

Responsibilities

• Establish and build strong relationships with internal team members and partner providers to foster a collaborative environment.
• Educates on and coordinates community resources, emphasizing medical, behavioral, and social services.
• Manages an active caseload based on state-mandated ratios according to residential setting, case intensity, and acuity.
• Collect program data to track participant progress on a monthly basis to ensure OPS reporting deadlines and compliance.
• Prepare reports regarding service provision and update service plans in accordance with governing bodies.
• Lead the PCSP process and oversee the implementation of PCSPs; assist Members in obtaining HCBS services for independent living.
• Identify, coordinate, and assist Members in gaining access to LTSS and Medical Assistance, plus non-Medicaid funded services.
• Inform Members about LTSS options, assessments, DHS Fair Hearing rights, risks, and responsibilities; assist with hearing requests.
• Collect additional information: preferences, strengths, goals to inform PCSP; reevaluate level of care as needed.
• Work with the Member to maintain LTSS eligibility; explore coverage via MA, Medicare, private insurance, and community resources.
• Coordinate with others to ensure seamless delivery of care and maintain HIPAA confidentiality; comply with regulations.
• Willingness and ability to work in the field 75% of the time and in a virtual setting when needed.

Skills

case management

care coordination

in-home assessments

adult populations

Job description

UPMC Health Plan is seeking Service Coordinators in Monroe Pike, PA area for the Community HealthChoices team. Hybrid position requiring daily community travel, serving seniors and individuals with disabilities under LTSS.

Responsibilities include managing caseloads, coordinating resources, and ensuring timely assessments and PCSP implementation to support independent living and access to LTSS and Medical Assistance.