Hybrid LTSS Care Coordination Specialist

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 42,000 - 64,000; Full time

Job summary

UPMC Health Plan is seeking Service Coordinators to support the Community HealthChoices program in Blair and Cambria Counties. This hybrid role requires daily community visits, with a focus on coordinating LTSS and HCBS services to help members live safely at home.

The position emphasizes in-home assessments, strong case management, and collaboration with providers and internal teams to meet regulatory requirements and improve health outcomes.

Qualifications

• Strong background in case management and care coordination.
• Experience conducting in-home assessments and visits.
• Experience working with adults with complex medical, behavioral, and social needs.
• Compassionate, resourceful, and committed to helping participants remain safely at home.

Responsibilities

• Establish relationships with internal teams and providers; educate on community resources.
• Manage an active caseload per state ratios and track progress for reporting.
• Prepare reports and update service plans; ensure timely comprehensive assessments.
• Lead PCSP process and assist Members in obtaining HCBS services.
• Coordinate LTSS and Medical Assistance services and help access non‑Medicaid supports.
• Inform Members about LTSS, rights, and fair hearing processes; assist with requests.
• Collect information to inform PCSP; reevaluate level of care annually.
• Help Members maintain LTSS eligibility and explore coverage options.
• Coordinate with needed entities to ensure seamless care; uphold HIPAA compliance.
• Work in the field ~75% of the time; ability to work independently in virtual settings.

Skills

Case management

Care coordination

In-home assessment

Adults with complex needs

Education

Bachelor's degree in social work or related field

Job description

UPMC Health Plan is seeking Service Coordinators to support the Community HealthChoices program in Blair and Cambria Counties. This hybrid role requires daily community visits, with a focus on coordinating LTSS and HCBS services to help members live safely at home.

The position emphasizes in-home assessments, strong case management, and collaboration with providers and internal teams to meet regulatory requirements and improve health outcomes.