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Clinical Prevention Specialist (RN)

  • Job ID: 210001QQ
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: UEG Clinical Care Mgmt
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: non union
  • Salary Range: $36.11 to $61.13 / hour


UPMC Health Plan is hiring a full-time Clinical Prevention Specialist to support the UEG Clinical Care Management Department for its downtown Pittsburgh location at the US Steel Tower. This is primarily a Monday through Friday daylight position.  This role will work remotely with the potential for in-person meeting attendance at the US Steel Tower in downtown Pittsburgh.

The ideal candidate will be self-motivated and empathetic with a passion for condition management.


  • Uses proactive listening and assessment skills to provide service to complex high-risk members enrolled in Clinical Decision Support. 
  • Applies critical thinking, innovative problem solving, and clinical motivational interviewing support skills to promote quality member-driven decisions.
  • Successfully engage members to develop an individualized plan of care while supporting the partnership with their primary care provider to promote a healthy lifestyle, decrease medical costs, and reduce unnecessary ER utilization and hospital readmissions. 
  • Assist member holistically with transition of care between health care facilities while collaborating with other Health Plan staff. 
  • Provide telephonic Clinical Decision Support to individuals and their families. 
  • Research members previously diagnosed medical conditions to better understand the diagnosis, interaction with other diagnoses, and treatment options. 
  • Discuss members’ desired treatment outcomes, wellness options, lifestyle, and health goals. Provide guidance in navigating multiple specialists, diagnoses, and pharmaceutical treatments. 
  • Present or contribute to complex case reviews to the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, unplanned days, and interventions. Communicate recommendations to the member. 
  • Maintain quality documentation of service delivery within HealthPlaNET.
  • Maintains patient confidentiality, adhering to UPMC Health Plan’s HIPAA & Privacy Policies & Guidelines.
  • Initiates, develops, and maintains effective working relationships with the clinical prevention team.


  • Graduate of an NLN accredited School of Nursing.
  • Registered Nurse with current licensure.
  • Master's of Science in Nursing or related field.
  • Minimum 5 years nursing experience.
  • Excellent verbal communication and with individuals and groups.
  • Work independently with excellent organization, and time management skills.

Licensure, Certifications, and Clearances:

  • Registered Nurse (RN)

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   Current UPMC employees must apply in HR Direct