Community HealthChoices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth, as well as dual-eligible individuals covered by Medicare and Medicaid.
This exciting Service Coordinator position requires local travel based on each participant's location. This opportunity is available in all counties including Greene, Fayette, and Washington County.
To provide service coordination services across the continuum of care through a community-based approach to improve health outcomes of the Members served. Service coordination's purpose is a for a collaborative process that assesses, plans, implements coordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes.
Actively coordinates with other individuals and entities essential in the physical and behavioral care delivery for the Member to provide for seamless coordination between physical, behavioral and support services
Assist Members in obtaining HCBS services that will support independent living
Assist the Member and his or her PCPT in identifying and choosing willing and qualified Providers
Collects additional necessary information, including, at a minimum: Member preferences, strengths and goals to inform the development of the PCSP Conducts reevaluation of level of care annually or more frequently as needed
Explores coverage of services to address Member identified needs through other sources, including services provided under Medical Assistance , Medicare or private insurance and other community resources
Identify, coordinate and assist Members 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
Informing Members about available LTSS, required assessments, the Person t-centered service planning process, service alternatives, service delivery options including opportunities for Self -direction, roles, rights including DHS Fair Hearing rights, risks and responsibilities, and to assist with fair hearing requests when needed and requested, and to protect a Members health, welfare and quality on on-going basis
Lead the Person-Centered Service Planning (PCSP) process and oversee the implementation of PCSPs
Providing information to Members and facilitating access, coordinating and monitoring LTSS needs for Members
Works with the Member to complete activities necessary to maintain LTSS eligibility
Bachelor's degree in Social Work, Psychology, or other related fields
At least three years working in social service or health care related setting Completion of person-centered planning and person-centered direction training
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
Experience conducting LTSS needs assessments and monitoring LTSS delivery
Cultural competency and the ability to provide informed advocacy
Ability to interact with physicians and other health care professionals in a professional manner is required
Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities
University Of Pittsburgh Medical Center