Community HealthChoices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth, as well as dual-eligible individuals covered by Medicare and Medicaid. 

 
To provide service coordination services across the continuum of care through a community-based approach to improve health outcomes of the Members served. Service coordination's purpose is a for a collaborative process that assesses, plans, implements coordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes.

Responsibilities:

• Actively coordinates with other individuals and entities essential in the physical and behavioral care delivery for the Member to provide for seamless coordination between physical, behavioral and support services
• Assist Members in obtaining HCBS services that will support independent living
• Assist the Member and his or her PCPT in identifying and choosing willing and qualified Providers
• Collect s additional necessary information, including, at a minimum: Member preferences, strengths and goals to inform the development of the PCSP Conducts reevaluation of level of care annually or more frequently as needed
• Explores coverage of services to address Member identified needs through other sources, including services provided under Medical Assistance, Medicare or private insurance and other community resources
• Identify, coordinate and assist Members in gaining access to needed LTSS and Medical Assistance services, as well as non-Medicaid funded medical, social, housing, educational, and other services and supports
• Informing Members about available LTSS, required assessments, the Person t-centered service planning process, service alternatives, service delivery options including opportunities for Self -direction, roles, rights including DHS Fair Hearing rights, risks and responsibilities, and to assist with fair hearing requests when needed and requested, and to protect a Members health, welfare and quality on on-going basis
• Lead the Person-Centered Service Planning (PCSP) process and oversee the implementation of PCSPs
• Providing information to Members and facilitating access, coordinating and monitoring LTSS needs for Members
• Works with the Member to complete activities necessary to maintain LTSS eligibility

• Bachelor's degree in Social Work Psychology or other related fields
• At least three years working in social service or health care related setting
• Completion of person-centered planning and person-centered direction training 
• Experience working with people with disabilities or seniors in need of LTSS
• Knowledge of the home and community-based service system and how to access and arrange for services
• Experience conducting LTSS needs assessments and monitoring LTSS delivery
• Cultural competency and the ability to provide informed advocacy 

• Ability to interact with physicians and other health care professionals in a professional manner is required
  
  Licensure, Certifications, and Clearances:
  

Driver's License

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