[Hiring] Telephonic Care Manager (RN) - Medicaid Case Management @UPMC

Role Description

Are you an experienced nurse with an interest in care management? Do you have a passion for the long-term care management of patients with chronic conditions? Is project management something you're experienced with and enjoy doing? We are looking for you!

UPMC Health Plan is hiring a full-time Telephonic Care Manager to support our Community Medicine Inc. team and PCMH Learning Network initiatives, primarily serving UPMC for You Medicaid members. This telephonic role is primarily remote, with standard daylight hours (Monday–Friday) and occasional travel within Pennsylvania.

The Telephonic Care Manager is responsible for care coordination and health education for identified Health Plan members through telephonic collaboration with members and their caregivers and providers. Responsibilities include:

• Identifying members' medical, behavioral, and social needs and barriers to care.
• Developing a comprehensive care plan that assists members to close gaps in preventive care, addresses barriers to care, and supports the member's self-management of chronic illness based on clinical standards of care.
• Collaborating and facilitating care with other medical management staff, other departments, providers, community resources, and caregivers to provide additional support.
• Following members by telephone or other electronic communication methods.

Qualifications

• Minimum of 2 years of experience in a clinical setting and case management nursing required.
• BSN preferred.
• Project Management experience is a bonus!
• Ability to interact with physicians and other health care professionals in a professional manner required.
• Excellent verbal and written communication and interpersonal skills required.
• Computer proficiency required.
• Meet minimum internet system/service and speed/latency requirements as set forth by UPMC.
• Private, secure designated workspace required in the home office setting or the ability to work from a designated UPMC office location daily.

Requirements

• Case management certification or approved clinical certification preferred.
• Registered Nurse (RN).
• Act 34 clearance.
• Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state.
• Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.