Hybrid CHC Service Coordinator – Nursing Facilities

UPMC; Northern (KY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

UPMC Health Plan seeks a full-time CHC Service Coordinator, Nursing Facilities, to support Community HealthChoices in Perry & Cumberland Counties. The role involves traveling about half the time to multiple nursing facilities and working a hybrid schedule Monday through Friday.

The position focuses on coordinating care across medical, behavioral, and social services to improve health outcomes for CHC members, while managing caseloads and leading PCSP processes within regulatory guidelines.

Qualifications

• Must be legally authorized to work in the United States without visa sponsorship.
• Hybrid work arrangement: daylight hours, Monday–Friday.
• Travel to nursing facilities required up to 50% of the time.

Responsibilities

• Establish and build strong relationships with internal team members and partners to provide and foster 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 on a monthly basis to ensure OPS reporting complete per regulatory deadline and compliance requirements.
• Lead the Person-Centered Service Planning (PCSP) process and oversee the implementation of PCSPs.
• Assist members in obtaining services that will support them while living in a Nursing Facility.
• Identify, coordinate, and assist members in gaining access to needed LTSS and Medical Assistance services, as well as non-Medicaid funded medical, social, housing, educational, and other services and supports.
• Provide information to members and facilitate access, coordinating and monitoring LTSS needs for members.
• Inform members about available LTSS, required assessments, the PCSP process, service alternatives, and service delivery options.
• Assist with fair hearing requests when needed and requested.
• Maintain confidentiality and HIPAA compliance.

Skills

Relationship building

Resource coordination

Caseload management

Data reporting

HIPAA compliance

Job description

UPMC Health Plan seeks a full-time CHC Service Coordinator, Nursing Facilities, to support Community HealthChoices in Perry & Cumberland Counties. The role involves traveling about half the time to multiple nursing facilities and working a hybrid schedule Monday through Friday.

The position focuses on coordinating care across medical, behavioral, and social services to improve health outcomes for CHC members, while managing caseloads and leading PCSP processes within regulatory guidelines.