COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Professional Care Manager, Part-Time

  • Job ID: 840084470
  • Status: Part-Time
  • Regular/Temporary: Regular
  • Hours: Monday through Friday
  • Shift: Day Job
  • Facility: UPMC East
  • Department: Case Management
  • Location: 2775 Mosside Blvd, Monroeville PA 15146
  • Union Position: No
  • Salary Range: $26.80 to $45.94 / hour

Description

UPMC East is hiring a Part-Time Professional Care Manager to help support UPMC East Intensive Care Unit.

This position is eligible for a generous sign-on bonus! If you are an experienced nurse looking to join UPMC, apply now!


Sign-On Bonus Details:

 


 $3,000 for registered nurses with one or more years of experience
Candidates hired into a sign-on bonus eligible role will be asked to make a one-year work commitment.

Purpose:

  • The Care Manager (CM) coordinates the clinical and financial plan for patients.
  • Performs overall utilization management, resource management, discharge planning and post-acute care referrals and authorizations.
  • Works with multi-disciplinary team in resource management, discharge planning and care facilitation.


Responsibilities:

 

  • Reviews medical record daily to ensure patient continues to meet LOC requirements and that chart documentation supports LOC determination.
  • Works with Physician Advisor and Attending Physicians to obtain necessary documentation to support current LOC, alters LOC as needed and expedites discharge planning for patients who no longer require hospital services.
  • Collaborates with patients, caregivers, internal/external healthcare providers, agencies and payers to plan and execute a safe discharge. Re-evaluates and revises discharge plan as patient clinical condition merits.
  • Develops alternative/multiple discharge plans in anticipation of patient need for post-acute services.
  • Uses InterQual criteria to justify appropriate LOC (Skilled, Rehab, Home Care, DME, etc.) and obtain all necessary payer authorizations for post-acute care. Documents Freedom of Choice re: post-acute services.
  • Serves as resource to clinical and finance teams for clinical documentation requirements, level of care, insurance coverage issues, specific payer and government policies and post-acute services coverage and availability.
  • Attends Department meetings and Corporate Care Management Training sessions in order to maintain current knowledge of all payer and regulatory requirements, UPMC CM policies and procedures, community resources.
  • Ensures compliance with all payer and government regulations.
  • Promotes patient safety. Supports CORE measures information for JCAHO requirements.
  • Takes leadership role in concurrent denial process. W
  • orks with Care Management Director, Physician Advisor, Attending Physicians and clinical team to obtain necessary information and documentation to support LOC.
  • Initiates acceptance of lower LOC when appropriate with assistance from billing office.
  • Obtains Consent to Appeal on Behalf of Member on all cases with concurrent denial.
  • Starts discharge planning on admission and ensures DC documentation is completed and updated regularly.
  • Proactively identifies barriers to discharge and works with multi-disciplinary team to expedite care, monitor length of stay (LOS) and facilitate discharge.
  • Addresses complex clinical and social situations efficiently in order to avoid unnecessary delays in discharge.
  • Documents all Avoidable Days in CANOPY system.
  • Performs clinical review on admission and/or continued stay using InterQual criteria to determine appropriate level of care (Inpatient, OBS, etc.)
  • Obtains all necessary authorizations for level of care including admission and continued stay.
  • Follows payer-specific requirements to obtain and document authorizations.

 

Qualifications

  • Graduate of approved school of nursing.
  • 2 years of nursing experience required.
  • BSN or related Bachelors degree preferred.
  • Previous case management experience preferred.
  • Knowledge of healthcare financial and payor issues preferred.
  • Knowledge of state, local, and federal programs preferred.
  • Use of InterQual criteria preferred.


Licensure, Certifications, and Clearances:

  • Current licensure as a Registered Professional Nurse either in the state where the facility is located or in a state covered by a licensure compact agreement with the state where the facility is located.
  • UPMC Corporate Care Management Training Certificate of Completion required with 4-6 weeks of hire.
  • UPMC approved Care Management certification preferred
  • Basic Life Support (BLS)
  • Registered Nurse (RN)
  • Act 34

 

UPMC advocates that anyone who can be vaccinated should be vaccinated. This serves to protect you and your loved ones, our patients, members, and communities.

The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure individuals either get vaccinated or receive a requested medical or religious exemption by Jan. 27. For individuals who choose an mRNA vaccine, a second dose of Pfizer or Moderna must be received by Monday, Feb. 28, or within the designated timeframe after your first dose is received.

While the first CMS deadline of Jan. 27 has passed, it’s not too late to get your first shot or request a medical or religious exemption. We each play a part in reaching 100% in our COVID-19 vaccination efforts.

If you previously chose not to be vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC, or visit a non-UPMC provider or UPMC Urgent Care location.

 

UPMC is an Equal Opportunity Employer/Disability/Veteran

 

COVID-19 Vaccination Information

Individuals hired into this role must comply with UPMC’s COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.

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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.

   Current UPMC employees must apply in HR Direct