University of Pittsburgh Physicians is hiring a full-time Service Coordinator II position to join their team in Oakland, PA. This position is a Beckwith Grant funded role that will spearhead implementation, assessment and programmatic management of a Collaborative Care Behavioral Health model embedded with a large multidisciplinary academic primary care team. You will work Monday-Friday daylight hours.

The ideal candidate will be looking to make an impact through building out this behavioral health program. The individual in this role will need to engage in both clinic care and program management. The providers in the department are open minded and supportive of learning. This role can provide licensure supervision hours for candidates pursing licensure in their respective field.

Responsibilities:

Patient Assessment and Engagement

• Conduct behavioral health screenings and psychosocial assessments.
• Identify patient needs, strengths, barriers to care, and treatment goals.
• Engage patients through motivational interviewing and patient-centered communication techniques.

• Assist patients in developing self-management skills and wellness plans.

   

Care Coordination

• Facilitate referrals among primary care providers, psychiatric consultants, therapists, specialists, and community organizations.
• Monitor patient follow-through with treatment recommendations.
• Address barriers related to transportation, insurance, housing, food insecurity, and other social determinants of health.

Clinical Monitoring and Follow-Up

• Maintain regular contact with patients through telephone, telehealth, and in-person encounters.
• Track symptom improvement using standardized measures such as PHQ-9, GAD-7, and other validated screening tools.
• Monitor treatment adherence and response to interventions.
• Escalate clinical concerns, including safety risks, to appropriate providers according to established protocols.
• Maintain patient registries and caseload tracking systems.
• Review patient panels to identify individuals requiring outreach or intervention.
• Support measurement-based care and quality improvement initiatives.
• Generate reports and assist with program outcome monitoring.

Team Collaboration

• Participate in interdisciplinary case review meetings.
• Present patient cases to psychiatric consultants and care teams.
• Collaborate with providers to develop and update treatment plans.
• Documentation and Compliance
• Document patient encounters accurately and timely in the electronic health record (EHR).
• Ensure compliance with HIPAA, organizational policies, and regulatory requirements.
• Maintain records necessary for quality reporting and program evaluation.