[Hiring] CHC Assistant Service Coordinator @UPMC

Role Description

Community Health Choices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid. The CHC Assistant Service Coordinator assists in providing service coordination services across the continuum of care through a community-based approach to improve health outcomes of the Participant served. This role contributes to the LTSS care coordination process by providing telephonic support to Participants and Service Coordinators through a collaborative process to promote quality, cost-effective outcomes.

This entry-level coordinator is responsible for outreach activities to Assigned Enrollees in need of complex care management and LTSS CP supports, including but not limited to:

• Online research
• Phone calls
• Emails
• Documentation in the electronic platform
• Complying with all data entry, data integrity, and data tracking requirements

This is a full-time position working Monday through Friday daylight hours and will be a remote position; however, must reside in Pennsylvania due to geographic hiring requirements.

Responsibilities

• Establish and build strong relationships with both internal team Participants and partner providers to foster a collaborative environment.
• Assist Enrollees in navigating and accessing LTSS services or programs and/or eliminating duplication of services.
• Share the Care Plan with parties who need it in connection with their supports of the Participant.
• Collect program data to track participant progress on a monthly basis to ensure OPS reporting is completed per regulatory deadline and compliance requirements.
• Perform professional-level administrative duties involving research, analysis, and reporting.
• Prepare reports regarding service provision and update service plans in accordance with governing bodies.
• Assist with Service Coordinators and Service Coordinator Associates with escalation issues.
• Conduct monthly and other calls to participants.
• Research and assist in resolving authorization issues, including securing providers and assisting in obtaining authorizations.
• Assist Participants in obtaining HCBS services that will support independent living.
• Identify, coordinate, and assist Participants in gaining access to needed LTSS and Medical Assistance services, as well as non-Medicaid funded medical, social, housing, educational, and other services and supports.
• Provide information to Participants and facilitate access, coordinating and monitoring LTSS needs for Participants.
• Inform Participants about available LTSS, required assessments, the Person-centered service planning process, service alternatives, and service delivery options.
• Assist with fair hearing requests when needed and requested, and protect a Participant's health, welfare, and quality on an ongoing basis.
• Collect additional necessary information, including Participant preferences, strengths, and goals to inform the development of the PCSP.
• Conduct reevaluation of level of care annually or more frequently as needed.
• Assist the Participant and his or her PCPT in identifying and choosing willing and qualified Providers.
• Work with the Participant to complete activities necessary to maintain LTSS eligibility.
• Explore coverage of services to address Participant identified needs through other sources.
• Actively coordinate with other individuals and entities essential in the physical and behavioral care delivery for the Participant.
• Ensure compliance with all state and federal regulations and guidelines in day-to-day activities.
• Maintain confidentiality and adhere to HIPAA requirements.
• Perform in accordance with system-wide competencies/behaviors.
• Perform other duties as assigned.

Qualifications

• High School Diploma required.
• 2 years of data entry or customer service experience required.
• Preferred experience working with people with disabilities or seniors in need of LTSS.
• Knowledge of the home and community-based service system and how to access and arrange for services.
• Proficiently and effectively read, write, and communicate in English.
• Additional language capability is preferred.
• Communicate in a manner appropriate and respectful to the comprehension level of the consumer and/or family.
• Cultural competency and the ability to be sensitive to diverse backgrounds.
• Highly Preferred: Nursing Facility experience.
• Preferred: Minimum of 1 year of LTSS, Service Coordination, or Case Management experience.

Requirements

• Ability to work independently in a virtual setting and make outbound calls.
• Physical Demands: Moderate activity, sitting, standing, and walking.
• Internet Speed Requirements: Minimum speed of 20Mb/s download, 5Mb/s upload, less than 50ms ping, and under 10ms jitter.
• Licensure, Certifications, and Clearances: Act 34.

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.