Description

Under the general direction of the Senior Care Manger and the Director of Call Center Operations, the Care Manager is responsible for delivering the direct services of the LifeSolutions National Service Center. The Care Manager provides specific clinical and administrative services to employees and family members seeking information, crisis intervention, management consultation and linkage to supplementary LifeSolutions' community services. The Care Manager serves as the primary clinical resource to all callers, and the primary LifeSolutions consultant to supervisors when faced with deteriorating work performance problems of employees. In addition, the Care Manager serves as the primary linkage between our LifeSolutions affiliate providers and the workplace. The responsibility for affiliate provider relations, affiliate satisfaction with LifeSolutions, and affiliate servicing falls to the Care Manager with the support of the Senior Care Manager. The LifeSolutions Care Manager will provide telephonic counseling and coaching to LifeSolutions members in accordance with best practices and will attend supervision with the Director of Clinical Services. The LifeSolutions Care Manager will assist in the delivery of UPMC Resources for Life Program to the UPMC Health Plan's Medicare members.

Strong preferences: Phone center, crisis support, intake, and case management experience

This role is 100% work-from-home after the initial training period but the selected candidate should be local to PIttsburgh for any on-site meetings. 

Responsibilities:

• Serve as the clinical resource for all callers needing information, crisis intervention, referral to community resources, immediate triage or assessment, facilitating entry into an emergency room or routine linkage with our local LifeSolutions affiliates.
• Responsible for the collection of all LifeSolutions case data from callers and affiliates, creation of appropriate case records, tracking of all necessary missing data, providing case follow-up, case closing, and ensuring readiness of case file for affiliate claims.
• Identify difficulties with specific affiliates, need for transitioning to alternative providers, and identification of geographic areas needing an affiliate to better serve the local accounts. Assists the Senior Care Manager in recruitment of affiliate providers.
• Maintain positive relations and contact with our LifeSolutions affiliates and provide quick response to their requests for support, information, problem solving and supplies.
• Maintains a through understanding of the WorkLife services, the call flow process and the UPMC Resources for Life Program.
• Supports and adheres to the Department's and UPMCHS's policies, procedures, protocols, philosophy and mission, applying excellent customer service attitudes and behaviors in the performance of all job duties.
• Maintains an understanding of behavioral health/EAP WorkLife benefits /Wellness Best Practices.
• Provide ongoing coaching, support, and guidance to Provider Support Representative with the National Service Center particularly around Worklife referrals/tracking.
• Provide direct management consultations, documentation of consults, and linkage to subsequent management referrals. Manage all active referrals, including the process flow of mandatory, DOT, and Fitness-for-Duty referrals.
• Maintain affiliate provider files, claims history, complaints, and profiles of the provider's strengths/weaknesses.
• Proficient use of Daybreak, Health PlaNET and MC-400 software programs.
• Will deliver telephonic EAP services including triage, short term counseling, referrals and follow-up evaluation to members.
• Responsible for maintaining the National Service Center performance metrics including speed-to-answer, % of calls dropped, and rating of customer service.
• Under the direction of the Senior Care Manager, develop and implement operational improvements to streamline client flow and services. Recommend policy revisions and special needs as necessary.

Qualifications

• A Master's degree in Psychology, Social Work or related behavioral science with an emphasis on interpersonal skills and clinical diagnosis is required.
• Background must include 2-3 years of clinical experience in the areas of substance abuse, mental health counseling and family/marital therapy.
• Experience in supervisory consultation regarding employee performance/conduct problems preferred
• Current Licensure in the State of Pennsylvania (preferred).
• Certified Employee Assistance Professional (CEAP) or CEAP eligible or professional license preferred.
• Provider-relations experience within a behavioral setting would be seen as very valuable.
• Familiarity of an ability to work with community resources (preferred).
• Geriatric Training and experience (preferred).

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

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.