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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   Current UPMC employees must apply in HR Direct

Care Manager | Western Psychiatric Hospital

Description

Purpose:
The Care Manager will assist the inpatient treatment teams to ensure appropriate level of care for all patients. The Care Manager will coordinate insurance reviews including pre-certification, continued stay reviews, retrospective reviews, and denial/appeal activity and documentation as needed.

Responsibilities:

  • Demonstrates proficiency in Psych Consult Care Management, Psych Consult Provider, Medipac, & SharePoint.
  • Documents pertinent clinical information on the Care Management Abstract.
  • Participates in telecons, grievance hearings, and DPW pre-hearings/hearings.
  • Reviews and completes MA late pick-ups
  • Effective communication with WPIC management regarding authorization challenges, MCO changes, disposition challenges, updates regarding cases in denial, etc.
  • Completes accurate, timely, and thorough documentation in the Psych Consult Care Management application.
  • Displays a positive attitude and be a helpful team member within the CM department.
  • Participates in departmental performance improvement projects.
  • Completes pre-certification and continued stay reviews within the designated MCO timeframes.
  • Gathers and maintains current patient progress from unit documentation, treatment team meetings, disposition meetings, etc.
  • Maintains a thorough understanding of Care Management standards and processes as defined the various managed care organizations.
  • Writes letters for provider appeals, member grievances, & DPW requests.
  • Collaborates with multiple departments within UPMC (e.g. Fiscal, Patient Access, DEC, and PBS).
  • Coordinates MD-MD reviews with the MDs and CM administrative staff.

Qualifications

  • RN or Master's level degree required, plus 3 years of clinical experience.
  • Managed Care Experience preferred

Licensure, Certifications, and Clearances:

  • Registered Nurse (RN)
  • Act 31 Child Abuse Reporting with renewal
  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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