Job Description

Job Title: Coordinator, Care Management (Evening)
Job ID: 724834
Status: Full-Time
Regular/Temporary: Regular
Hours: 3:30p - 12:00a
Shift: Day Job
Facility: Community Care Behavioral Hlth
Department: Care Management Precert
Location: 336 Sixth Avennue, Pittsburgh PA 15222

Description

Do you have an active PA health/human services licensure and at least five years of clinical behavioral health experience? Do you have a background working in mental health or with drug/alcohol services? If so, UPMC may have the perfect fit for you!

 

UPMC is hiring a full-time Coordinator, Care Management to support our Community Care Behavioral Health (CCBH) team. This is a Monday through Friday evening position (3:30 p.m. - 12:00 a.m.) and will support the 24-hour Precert team. The Coordinator, Care Management must be able and willing to work an on-call rotation (about once every 5 weeks). This position will be located in Pittsburgh, PA.

 

 

Experience in mental health or drug/alcohol services is preferred.

 


The Coordinator of Care Management has over-all responsibility for managing daily operations on the floor. This individual is responsible for the clinical administrative supervision and management of the specified care management teams. The manager ensures provision of clinical services consistent with all applicable policies and procedures. The manager represents the organization to providers, member groups and families, and participates in overall clinical operations management as warranted.

Responsibilities:

  • Acts with the authority of the Director of Care Management and Member Services when designated.
  • Adheres to guiding principles of the organization.
  • Advanced clinical knowledge.
  • Assumes daily responsibility for the access and quality of services provided to Community Care members through the care management department.
  • Attends case conferences, interagency and provider treatment planning meetings for members when the assigned care manager is unavailable or when the assigned care manager requires clinical administrative support.
  • Coordinates the complaint and grievance process for members.
  • Coordinates, reviews and maintains data for reporting purposes and for weekly preparation and analysis of trending reports.
  • Demonstrates excellent clinical, written and oral communication skills.
  • Demonstratres leadership.
  • Independently problem solves based on sophisticated knowledge of behavioral health services for children and adults, the provider network, policies, members' rights and responsibilities, and the operating practices of the organization.
  • Knowledge of Community Resources.
  • Maintains an up-to-date understanding of benefits, in-plan services, and the regulatory environment and remains current on covered benefits, limitations, exclusions, and policies and procedures.
  • Meets with members and families, primary care and behavioral health providers, and other agency staff as needed to develop and coordinate services.
  • Monitors daily activity to ensure that services of the department are provided within standards.
  • Participates in CQI activities and provider training, and participates in professional development activities.
  • Participates in making presentations to participating providers, state and federal agencies, community groups and other interested parties.
  • Proposes and implements creative solutions to problems and to achieve a high level of member satisfaction with services.
  • Provides accurate information concerning benefits and coverage to staff or other persons as required.
  • Provides oversight of the teams providing clinical reviews, service authorization, and care coordination for all Community Care members.
  • Receives and responds to complex calls to assist in their resolution.
  • Responsible for directly assisting daily operations of the unit when scheduled staff are unable to perform their duties.
  • Responsible for providing after-hours call support and supervision as required by the scheduled personnel.
  • Responsiveness to deadlines and has work completed on or before deadline 95% of the time.
  • Supervises collection of information regarding the delivery and outcomes of Community Care services to members, and uses that information to recommend modifications to plan policies and procedures intended to improve the delivery of services to members.
  • Utilizes supervision effectively. Reports clinical, utilization and outcomes issues to Director of Care Management and Member Services. Identifies provider issues and recommendations for improvement.
  • Well-organized, reliable and dependable.
  • Works as part of the management team in collaboration with Member Services, Network Management and Quality Management departments to assure that systematic revisions to improve services are developed and implemented.
  • Works closely with the director in the continued development of the care management department.
  • Works with Network Management and Quality Management staff to assure that systematic revisions to improve services are developed and implemented.
  • Works with internal network staff and providers to identify opportunities for the development of alternative or non-traditional services to best meet members' needs.

Qualifications

  • Pennsylvania licensure and masters degree in health-related field;
  • or licensed RN with BSN
  • 5 years of clinical behavioral health experience.
  • Management/leadership experience in behavioral health preferred.
  • Experience in managed care strongly preferred
  • General knowledge of best practices in behavioral health, emphasizing work with special needs populations and in public sector systems.
  • Strong working knowledge of managed care functional areas, including terms and definitions.

Licensure, Certifications, and Clearances:
Pennsylvania licensure: LSW, LCSW, LPC, licensed MFT, licensed RN (with BSN) and/or a licensed PhD (psychologist)

  • Act 33 Child Clearance with Renewal
  • Act 34 Criminal Clearance with Renewal
  • Act 73 FBI Clearance
  • Behavior Specialist or Clinical Social Worker or Licensed Marriage & Family Therapist or Licensed Professional Counselor or Licensed Social Worker or Psychologist or Registered Nurse

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $28.37 to $47.88

Union Position: No

Apply Current Employee?

UPMC VALUES

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.


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