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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Quality Management Clinician (Delaware County)

  • Job ID: 884647917
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Community Care Behavioral Health
  • Department: Start-up
  • Location: 6505 Market Street, Upper Darby PA 19082
  • Union Position: No
  • Salary Range: $24.78 to $42.84 / hour

Description

Join a team where your community is our first priority. At Community Care Behavioral Health (CCBH), we’re committed to giving your neighbors the quality of life that they deserve. A proud part of the UPMC Insurance Services Division, we provide members with the behavioral health treatment they need for better health and a higher quality of life, including treatment for mental health conditions, drug or alcohol addiction, and developmental disabilities.

We are hiring a full-time Quality Management Clinician to support the Quality Department within Community Care Behavioral Health Organization (Community Care) business unit. This will be a Monday through Friday daylight schedule. The Quality Management Clinicians will be based out of the Delaware County office location.  This is a hybrid role with travel to the office, provider sites and/or county offices as well as some opportunity for remote work.

Quality Management Clinicians are responsible for performing functions related to quality management and improvement, in compliance with NCQA, HEDIS, URAC, QARR, and state quality assurance regulations.

Responsibilities:

  • Responsible for participating in projects as designated by other management staff, such as the Chief Medical Officer and VP of Medical Affairs.
  • Responsible for performing targeted, clinical audits and focus studies.
  • Responsible for logging in, tracking, monitoring, and reporting individual and aggregate complaints and grievances to the Senior Director of Quality Management and other leadership staff members as appropriate. Prepares formal reports and tracks timing of various levels of complaint and grievance for further action.
  • Responsible for assisting with preparation for NCQA, URAC, and other site visits.
  • Responsible for participating in updating the QM Plan.
  • Responsible for monitoring quality tracking reports and providing individual feedback to appropriate staff/committees, and aggregating the data on a monthly basis.
  • Responsible for identifying trends related to product and participating providers.
  • Responsible for preparing monthly and quarterly quality improvement reports to the Board.
  • Responsible for specified data collection related to all functional departments of Community Care.
  • Responsible for assisting with training responsibilities for providers, Members, and staff on various issues as assigned by the Senior Director of Quality Management.
  • Responsible for professional and staff development plan.

 

Qualifications

  • Licensed Registered Nurse (BSN preferred) or Masters Degree (licensure preferred).
  • 3 years of clinical experience.
  • Experience in Quality Management procedures/processes preferred.
  • Knowledge of URAC, NCQA, and HEDIS standards preferred.
  • Experience in managed care preferred.
  • Excellent organizational skills.
  • Experience in report writing, Microsoft Access, Microsoft Excel, collection and organization of large quantities of data.
  • Ability to maintain effective professional liaison with all levels of staff, including professional and institutional providers of care.
  • Independent problem solving related to job responsibilities based on knowledge of quality standards, clinically pertinent issues related to product and population served, and the operating practices of this organization.
  • Ability to identify trends or problem areas.
  • Demonstrates clinical knowledge of behavioral health-related issues.
  • Ability to propose and, with supervision, implement solutions to identified trends or problem areas with recommendations for improvement.
  • Excellent clinical, written, and oral communication skills.
  • Responsiveness to deadlines and has work completed on or before deadline 95% of the time.


Licensure, Certifications, and Clearances:

  • Pennsylvania licensure: LSW, LCSW, LPC, licensed MFT, licensed RN (with BSN) and/or a licensed PhD (psychologist) preferred.


UPMC is an Equal Opportunity Employer/Disability/Veteran

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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

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