Hybrid Care Coordinator – LTSS (Home & Community)

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 42,000 - 68,000; Full time

Job summary

UPMC Health Plan is seeking Service Coordinators to join the Community HealthChoices team in a hybrid role requiring daily community travel. You will coordinate services, assess needs, and support adults with complex medical and social needs to live safely at home.

The role emphasizes case management, data tracking, and collaboration with providers to ensure timely assessments and service plans, with field work constituting most duties.

Qualifications

• Bachelor's degree in social work, psychology, or related field preferred.
• Experience in case management and care coordination.
• Experience conducting in-home assessments and visits.
• Ability to work with adults with complex medical, behavioral, and social needs.
• Strong communication and collaboration with care teams.
• Willingness to travel daily to community locations.

Responsibilities

• Establish and build relationships with internal teams and partner providers to coordinate resources.
• Manage an active caseload based on regulatory ratios; track progress and submit OPS data.
• Prepare reports, update service plans, and ensure timely assessments.
• Lead PCSP process and assist Members in obtaining LTSS and HCBS services.
• Identify and assist Members in accessing LTSS, Medicaid, Medicare, and other services.
• Inform Members about LTSS, fair hearing rights, and help with requests.
• Collect member information to inform PCSP; reevaluate level of care annually.
• Work with Members to maintain LTSS eligibility and explore coverage options.
• Coordinate with care providers to ensure seamless delivery; maintain HIPAA confidentiality.
• Willingness to work in the field 75% of the time; work independently in a virtual setting.

Skills

Case management

Care coordination

In-home assessments

Adult population care

Field work

HIPAA compliance

Education

Bachelor's degree in social work, psychology, or related field

Job description

UPMC Health Plan is seeking Service Coordinators to join the Community HealthChoices team in a hybrid role requiring daily community travel. You will coordinate services, assess needs, and support adults with complex medical and social needs to live safely at home.

The role emphasizes case management, data tracking, and collaboration with providers to ensure timely assessments and service plans, with field work constituting most duties.