UPMC Senior Service Coordinator in Camp Hill, Pennsylvania
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 who are covered by Medicare and Medicaid.
As a Senior Service Coordinator, you will provide service coordination services across the continuum of care through a community-based approach to improve the health outcomes of the Members served. The Senior Service Coordinator supports a collaborative process and 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. This role also acts as a Subject Matter Expert for the department in representing management in meetings, training new staff, integrating new case management initiatives in conjunction with management. Collect program data to monitor/ensure compliance requirements and establishes and revises better best practices within the department.
Partner with your leadership team and clinical staff to determine the best strategies to support our members. Ensure the day-to-day service coordination and service operations are functioning in accordance with agency philosophy and standards set forth in funding contracts and agency policy. Assists with implementation of new and expanding healthcare case management initiatives.
Represents supervisors and management in meetings or on special assignments. Helps establish process improvements leading to best practice and assist in implementing change management. Trains, mentors and provides guidance to new and current Field Service Coordinators regarding policy and procedure, systemic tools, workload, and care plan development.
Assist with large group presentations and training staff on Service Coordination as needed. Establish and build strong relationships with both internal team members and partner provider to foster a collaborative environment. Educates on and coordinates community resources with emphasis on medical, behavioral, and social services.
Manages an active caseload based on state-mandated ratios according to residential setting, case intensity, and acuity. Collect program data to track participant progress on a monthly basis to ensure to OPS reporting is completed per regulatory deadline and that compliance requirements are met per regulatory requirements. Responsible for performing profession-level administrative duties involving research, analysis, and reporting.
Prepare reports regarding service provision and update service plans in accordance with governing bodies. Ensures comprehensive assessments are completed within required time frames and utilizes knowledge and expertise to assess options for care including use of benefits and community resources. Lead the Person-Centered Service Planning (PCSP) process and oversee the implementation of PCSPs. Assist Members in obtaining HCBS services that will support independent living.
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. Providing information to Members and facilitating access, coordinating, and monitoring LTSS needs for Members. 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 an on-going basis.
Collect s 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. Assist the Member and his or her PCPT in identifying and choosing willing and qualified Providers. Works with the Member to complete activities necessary to maintain LTSS eligibility. 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.
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. Ensures compliance with all state and federal regulations and guidelines in day-to-day activities. Maintain confidentiality and adhere to HIPAA requirements.
Willingness and ability to work in the field at least 75% of the time. Ability to work independently in a virtual setting.
At times, the Sr. SC may be asked to support the on-call Supervisor or act as the primary on-call representative during a weekend shift on pre-planned, scheduled basis.
Service Coordinators must have a Bachelor's degree in social work, psychology, or other related fields with practicum experience preferred and two (2) years? experience OR have at least five (5) years of experience in a social service or a healthcare-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 be sensitive to diverse backgrounds and set aside personal opinions and implicit biases. This includes their basic principles, values, ethics, ways of thinking, customs, practices, and their impact on human culture. Preferred: Minimum of two (2) years of CHC LTSS AND Service Coordination experience.
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran