RN Utilization Care Manager – Flexible Weekend Hours

UPMC; Pittsburgh (Allegheny County); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Retirement plan

Paid time off

Job summary

UPMC Health Plan is hiring a flex full-time UM Care Manager to support our UM Clinical Operations team. The role involves 8-10 hour Saturday shifts with flexible weekday scheduling based on team needs and employee preference.

The candidate will work a minimum of 28 hours per week with potential up to 40 hours, enjoying full-time benefits including medical, dental, and vision coverage, retirement, PTO, and life insurance.

Responsibilities

• Obtain documentation to support requested level of care within regulatory timeframes and notify providers as applicable.
• Document activities in the care management tracking system per standards; identify trends for improvement.
• Review clinical information from providers (history, home environment, status) for authorization.
• Participate in interdisciplinary team conferences to discuss discharge plans.
• Collaborate with peers and departments to determine discharge needs and referrals.
• Maintain communication with providers regarding care plan determinations.
• Identify quality of care concerns and refer to quality management as needed.

Job description

UPMC Health Plan is hiring a flex full-time UM Care Manager to support our UM Clinical Operations team. The role involves 8-10 hour Saturday shifts with flexible weekday scheduling based on team needs and employee preference.

The candidate will work a minimum of 28 hours per week with potential up to 40 hours, enjoying full-time benefits including medical, dental, and vision coverage, retirement, PTO, and life insurance.