Job Description

Job Title: Mobile Social Services Case Manager – Health Plan (Lawrenceville)
Job ID: 20837129
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Medical Mgmt Medicaid
Location: 4401 Penn Avenue, Pittsburgh PA 15224

Description

UPMC Health Plan is currently hiring a full-time Mobile Social Services Case Manager to support the Medical Management Medicaid department. This will be a Monday through Friday daylight role (8:00 a.m. – 4:30 p.m. / 8:30 a.m. - 5:00 p.m.) and will be based out of UPMC Children's Hospital of Pittsburgh in the Lawrenceville neighborhood.

The Case Manager will work with children who have complex physical and behavioral health needs. Experience working with children/adolescents is preferred.

The Social Worker assists UPMC Health Plan members who require care coordination and conducts assessments that include behavioral, clinical, social, and environmental concerns or needs. The Mobile Social Service Case Manager will coordinate programs, services, and facilitate communication between the member's physicians, physical and behavioral health clinicians, and community-based services.

Responsibilities:
  • Conducts member assessments identifying behavioral, clinical, social, and environmental concerns and needs.
  • Makes referrals and provides expertise regarding community and governmental agencies.
  • Performs duties and responsibilities in accordance with the philosophy and standards of the UPMC Health Plan including conveying courtesy, respect, enthusiasm, integrity, innovation, and a positive attitude through contacts with staff, health plan members, peers, and external contacts.
  • Ensures that cases are managed and documentation is within established timeframes in accordance with departmental standards.
  • Assesses member's knowledge of their clinical condition and the need for further education
  • Identifies barriers to care and develops specific integrated plan of care in collaboration with the member, family, provider, and UPMC Health Plan staff.
  • Conducts face-to-face member assessments by visiting the member in the member's community, place of residence, or facility.
  • Coordinates care and services across the continuum of care with case management, physicians, pharmacy, behavioral health, and other providers or health plan departments as appropriate.
  • Coordinate with member's physicians to ensure follow-up and coordination of care
  • Participates in case conferences, interagency and provider treatment planning and departmental meetings.
  • Conduct on-site hospital coordination for discharge planning with facility staff if needed.

Qualifications

  • Master's degree in social work/human service field 
  • Three years of experience in behavioral, clinical, utilization management, home care, discharge planning, and case management required.
  • General knowledge of best practices in working with special needs populations in the public sector preferred.
  • Detail-oriented with excellent organization skills required.
  • High level of oral and written communication skills required.
  • Proficiency in Microsoft Office products is preferred and ability to learn new software applications required. 
  • Three years' experience in a managed care environment preferred 
  • Five years of experience with community-based case management, and behavioral health experience preferred.


Licensure, Certifications, and Clearances:

  • Licensed Mental/Behavioral Health Professional required.
  • CPR required based on AHA standards that include both a didactic and skills demonstration component within 30 days of hire
  • Automotive Insurance
  • Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR)
  • Clinical Social Worker (CSW) OR Licensed Professional Counselor (LPC) OR Licensed Social Worker (LSW)
  • Driver's License
UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $22.07 to $37.36 / hour

Union Position: No

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