RN Clinical Care Manager - Daytime In-Office Care Coordination

UPMC; Pittsburgh (Allegheny County); On-site; USD 65,000 - 85,000; Full time

Job summary

UPMC Health Plan is seeking a full-time Clinical Care Manager to support care coordination and health education for members in the Pittsburgh area. You will work face-to-face with members, caregivers, and providers in outpatient, home health, or case management settings.

Responsibilities include developing care plans, coordinating with multiple stakeholders, and addressing barriers to preventive care. The role requires RN licensure, 2+ years in clinical care, and 1 year in health insurance or

Qualifications

• Minimum of 2 years of experience in a clinical setting and case management nursing.
• BSN preferred.
• Minimum 1 year of health insurance experience required.
• 1 year of experience in clinical, utilization management, home care, discharge planning, and/or case management preferred.
• Excellent organizational skills.
• High level of oral and written communication skills.
• Computer proficiency required.

Responsibilities

• Assist member with transition of care between health care facilities.
• Document all activities in the health plan's care management tracking system.
• Engage member to develop an individualized plan of care with their PCP and providers.
• Coordinate and modify the care plan with member, caregivers, PCP, specialists, and community resources.
• Review medication profiles and address adherence issues with members and providers.
• Refer members to appropriate case management, health management, or lifestyle programs.
• Engage members in Beating the Blues or self-management programs.
• Provide education materials to enhance health knowledge.
• Schedule follow-up appointments after ER visits or hospitalizations.
• Plan standards and identify trends for improvement from member interactions.

Skills

Care coordination

Health education

Communication

Computer skills

Education

RN licensure

Bachelor of Science in Nursing

Tools

EMR/EHR

Job description

UPMC Health Plan is seeking a full-time Clinical Care Manager to support care coordination and health education for members in the Pittsburgh area. You will work face-to-face with members, caregivers, and providers in outpatient, home health, or case management settings.

Responsibilities include developing care plans, coordinating with multiple stakeholders, and addressing barriers to preventive care. The role requires RN licensure, 2+ years in clinical care, and 1 year in health insurance or