Description
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
UPMC is an Equal Opportunity Employer/Disability/Veteran
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Our Values
At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.