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Telephonic Care Manager (RN) - Medicaid Case Management at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Care Coordination, Health Education, Case Management, Chronic Disease Management, Patient Assessment, Care Planning, Medication Adherence Review, Interdisciplinary Collaboration, Project Management, Clinical Documentation, Patient Outreach, Interpersonal Communication
Specialization
Requires a Registered Nurse (RN) license and a minimum of 2 years of experience in a clinical setting and case management nursing. A BSN and case management certification are preferred.
Experience Required
Minimum 2 year(s)
Director, Quality Assurance/Operational Integrity at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Quality Assurance, Operational Integrity, Risk Mitigation, Auditing, Stakeholder Management, Strategic Planning, Regulatory Compliance, Ncqa Accreditation, Risk Assessment, Benchmarking, Performance Management, Business Planning, Technical Research, Financial Reporting, Managed Care Operations
Specialization
Requires a Bachelor's degree in Business or Accounting and at least 8 years of healthcare experience in quality review or auditing, including 5 years in management. Experience with NCQA accreditation and regulatory requirements for Medicare and Medicaid is essential.
Experience Required
Minimum 10 year(s)
OnCore Analyst Sponsored Research, Enterprises at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Oncore, Clinical Trial Management System, Application Design, System Integration, Data Quality Control, Technical Support, Cross Team Collaboration, Data Entry, Query Resolution, Software Implementation
Specialization
A bachelor's degree in a related field or equivalent experience is required, with a preference for experience in clinical research. Candidates should possess strong organizational skills and experience with CTMS or financial data systems.
Experience Required
Minimum 2 year(s)
Respiratory Therapist at UPMC
Everett, Pennsylvania, United States - Full Time
Skills Needed
Arterial Blood Gas Measurement, Mechanical Ventilation, Pulmonary Function Testing, Bronchopulmonary Drainage, Patient Assessment, Aerosol Therapy, Emergency Response, Clinical Data Interpretation, Patient Monitoring, Equipment Calibration
Specialization
Candidates must be graduates of a CoARC approved program and hold an RRT credential from the NBRC. Required certifications include a Respiratory Care Practitioner (RCP) license and BLS/CPR certification.
Electrical Journeyman at Accelevation
Atlanta, Georgia, United States - Full Time
Skills Needed
Electrical Installation, Electrical Maintenance, Troubleshooting, Blueprint Reading, Technical Drawing Interpretation, Conduit Bending, Cable Cutting, Compression Tools, Mechanical Lift Operation, Safety Compliance, Mentoring Apprentices, Emergency Response
Specialization
Requires a valid Journeyman Electrician License, a high school diploma, and at least 4 years of experience as an electrician. Proficiency with electrical tools and the ability to operate mechanical lifts are essential.
Experience Required
Minimum 2 year(s)
1st Shift Janitorial Office/Warehouse at SERVICEMAX INC
Anderson, South Carolina, United States - Full Time
Skills Needed
Cleaning, Sanitizing, Dusting, Sweeping, Mopping, Polishing, Scrubbing, Waste Management
Specialization
Candidates must be reliable, physically capable of standing for the entire shift, and able to work independently. No specific education or prior experience is listed as a requirement.
RN PRN Dialysis at Community Health System
Powell, Tennessee, United States - Full Time
Skills Needed
Patient Assessment, Medication Administration, Dialysis Machine Operation, Infection Control, Care Planning, Patient Education, Emergency Response, Clinical Documentation, Vital Signs Monitoring, Interdisciplinary Collaboration, Hemodynamic Monitoring, Patient Advocacy
Specialization
Candidates must have a valid Registered Nurse state license and BCLS certification, with ACLS, PALS, or NRP preferred. A minimum of 0-2 years of clinical nursing experience or acute care student rotations is required.
Event Coordinator (Weekends Only) at Nashville Shores
Nashville, Tennessee, United States - Full Time
Skills Needed
Event Coordination, Client Communication, Vendor Coordination, Multi Tasking, Interpersonal Skills, Oral Communication, Microsoft Office, Photoshop, Canva, Analytical Skills, Organization
Specialization
Candidates must be at least 18 years old and capable of lifting 25 to 30 pounds. Proficiency in Microsoft Office is required, with knowledge of Photoshop and Canva preferred.
Host - Canton at Trillium
Canton, Massachusetts, United States - Full Time
Skills Needed
Guest Service, Reservation Management, Communication, Multitasking, Organization, Attention To Detail, Teamwork, Time Management
Specialization
Candidates must be at least 18 years old and obtain TIPS training by their start date. Previous experience in a fast-paced restaurant setting is preferred along with the ability to perform physical tasks.
Physical Therapist at Alliance Residential Company
Tacoma, Washington, United States - Full Time
Skills Needed
Patient Evaluation, Evidence Based Practice, Patient Care Planning, Clinical Documentation, Patient Communication, Interdisciplinary Collaboration, Patient Mobility Assistance, Mentorship
Specialization
Must be a licensed or license-eligible Physical Therapist with a commitment to patient-first care. Candidates should possess a compassionate mindset and a desire for professional growth within a supportive team.
Assistant Director Childcare at LLE Education Group
Woodbridge, Virginia, United States - Full Time
Skills Needed
Leadership, Communication, Organization, Staff Management, Student Enrollment, Billing, Tuition Collection, Marketing, Public Relations, Bookkeeping, Parent Relations, Early Childhood Education
Specialization
Requires an early childhood professional credential or degree, at least one year of supervisory experience, and two years of teaching experience. Must complete Virginia Pre-Service Training and pass a background check.
Experience Required
Minimum 2 year(s)
CNC Machinist III at The Armor Group
Elkhart, Indiana, United States - Full Time
Skills Needed
Cnc Lathe Operation, Cnc Mill Operation, G Code Programming, Fixture Setup, Blueprint Reading, Precision Measuring Tools, Tool Offsets, Deburring, First Article Inspection, Work Coordinates, Microsoft Excel, Microsoft Access
Specialization
Requires a high school or vocational education with 4 years of relevant experience in CNC operation and G-code. Must be proficient with measuring tools, blueprint reading, and capable of lifting up to 65 pounds.
Experience Required
Minimum 2 year(s)
Sports Medicine Intern at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft Powerpoint, Administrative Support, Typing, Calendar Management, Office Equipment Operation, Data Entry, Customer Service
Specialization
A high school diploma is strongly preferred, and one year of administrative experience is highly desired. Proficiency in Microsoft Office Suite and the ability to use standard office equipment are required.
Science Teacher at ICAHN ENTERPRISES HOLDINGS LP
New York, New York, United States - Full Time
Skills Needed
Inquiry Based Instruction, Curriculum Alignment, Classroom Management, Student Assessment, Direct Instruction, Oral Communication, Written Communication, Collaborative Teaching
Specialization
Candidates must hold a Bachelor's degree and New York State certification in Science for grades 7-12. A Master's degree is preferred along with excellent communication skills.
Experience Required
Minimum 2 year(s)
Food & Beverage Coordinator at Icicle Brewing Co and Munchen Haus
Leavenworth, Washington, United States - Full Time
Skills Needed
Inventory Management, Kitchen Operations, Vendor Relations, Cost Control, Staff Scheduling, Budgeting, Food Safety Compliance, Recipe Development, Administrative Support, Team Leadership, Multi Tasking, Forecasting
Specialization
Candidates must have food and beverage experience, with supervisory experience in hospitality preferred. Required certifications include a Food Handlers Permit, Washington MAST Card, ServSafe Food Protection Manager, and Cicerone Certified Beer Server.
Experience Required
Minimum 2 year(s)
College Summer Intern at Aladdin Temp Rite
Hendersonville, Tennessee, United States - Full Time
Skills Needed
Design Engineering, Creative Marketing
Specialization
Applicants must be current college students or recent college graduates. The role is specifically for those interested in Design Engineering or Creative Marketing.
Resident Assistant at Flatrock
Washington Township, Ohio, United States - Full Time
Skills Needed
Personal Care, Medication Reminders, Mobility Support, Memory Care, Patient Monitoring, Interpersonal Communication, Cpr, First Aid
Specialization
Experience in memory care or assisted living is preferred, along with strong interpersonal skills and the ability to handle physical demands. Candidates should be reliable and patient, with CPR and First Aid certifications being a plus.
Phlebotomist - UPMC Carlisle at UPMC
Carlisle, Pennsylvania, United States - Full Time
Skills Needed
Phlebotomy, Venipuncture, Specimen Collection, Patient Identification, Medical Terminology, Laboratory Information Systems, Heelstick, Fingerstick, Arterial Puncture, Quality Control, Quality Assurance, Clerical Duties
Specialization
A high school diploma is required, while certification from an accredited Phlebotomy or Medical Assistant program and 6 months of experience are preferred. Candidates must obtain necessary clearances including FBI and Child Abuse reporting.
Telephone Operator - UPMC East at UPMC
Monroeville, Pennsylvania, United States - Full Time
Skills Needed
Telephone Operation, Customer Service, Emergency Coordination, Data Entry, Call Routing, Communication Skills, Multi Line Phone Systems, Detail Oriented
Specialization
Requires a high school diploma or equivalent and one year of experience in customer service or automated phone systems. Candidates must be available to work rotating shifts, including days, evenings, overnights, weekends, and holidays.
Community Manager at PTLA Real Estate Group
Hayward, California, United States - Full Time
Skills Needed
Leasing, Resident Relations, Marketing, Maintenance Management, Vendor Relations, Financial Reporting, Customer Service, Problem Solving, Fair Housing Compliance, Entrata, Spanish Bilingualism
Specialization
Requires a minimum of 2 years of property management and leasing experience and bilingual proficiency in Spanish. Candidates must have reliable transportation and be willing to live onsite at a designated property.
Experience Required
Minimum 2 year(s)
Telephonic Care Manager (RN) - Medicaid Case Management at UPMC
Pittsburgh, Pennsylvania, United States -
Full Time

Start Date

Immediate

Expiry Date

10 Aug, 26

Salary

0.0

Posted On

12 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Care Coordination, Health Education, Case Management, Chronic Disease Management, Patient Assessment, Care Planning, Medication Adherence Review, Interdisciplinary Collaboration, Project Management, Clinical Documentation, Patient Outreach, Interpersonal Communication

Industry

Hospitals and Health Care

Description
Purpose: 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 you 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. Identifies members' medical, behavioral, and social needs and barriers to care. Develops 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. Collaborates and facilitates care with other medical management staff, other departments, providers, community resources and caregivers to provide additional support. Members are followed by telephone or other electronic communication methods. Title and salary will be determined based upon education and nursing experience for Sr. Professional Care Manager within the Insurance Services Division. Responsibilities: Present complex members for review by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management interventions. Update the plan of care following review and communicate recommendations to the member and providers. Contact members with gaps in preventive health care services and assist them to schedule required screening or diagnostic tests with their providers. Review member's current medication profile; identify issues related to medication adherence, and address with the member and providers as necessary. Refers member for Comprehensive Medication Review as appropriate. Conduct comprehensive assessments that include the medical, behavioral, pharmacy, and social needs of the member. Review UPMC Health Plan data for services the member has received and identify gaps in care based on clinical standards of care. Refer members to appropriate health plan programs based on assessment data. Engage members in education or self-management programs. Provide members with appropriate education materials or resources to enhance their knowledge and skills related to physical health, emotional health, or lifestyle management. Successfully engage member to develop an individualized plan of care in collaboration with their primary care provider that promotes healthy lifestyles, closes gaps in care, and reduces unnecessary ER utilization and hospital readmissions. Coordinates and modifies the care plan with member, caregivers, PCP, specialists, community resources, behavioral health contractor, and other health plan and system departments as appropriate. Document all activities in the Health Plan's care management tracking system following Health Plan standards and identify trends and opportunities for improvement based on information obtained from interaction with members and providers. Conduct member outreach in response to assist with member issues or concerns or facilitate specific population health goals. Seek input from clinical leadership to resolve issues or concerns. 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. Equipment must be connected directly or hard-wired to the internet modem/router with an ethernet cable. Most cable and fiber optic providers can meet the requirement. Private, secure designated workspace required in the home office setting or the ability to work from a designated UPMC office location daily. Licensure, Certifications, and Clearances: Case management certification or approved clinical certification preferred Registered Nurse (RN) Act 34 *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. UPMC is an Equal Opportunity Employer/Disability/Veteran
Responsibilities
The Telephonic Care Manager provides care coordination and health education for Medicaid members to address medical, behavioral, and social needs. They develop comprehensive care plans to close gaps in preventive care and reduce unnecessary hospital readmissions.
Telephonic Care Manager (RN) - Medicaid Case Management at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Care Coordination, Health Education, Case Management, Chronic Disease Management, Patient Assessment, Care Planning, Medication Adherence Review, Interdisciplinary Collaboration, Project Management, Clinical Documentation, Patient Outreach, Interpersonal Communication
Specialization
Requires a Registered Nurse (RN) license and a minimum of 2 years of experience in a clinical setting and case management nursing. A BSN and case management certification are preferred.
Experience Required
Minimum 2 year(s)
Director, Quality Assurance/Operational Integrity at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Quality Assurance, Operational Integrity, Risk Mitigation, Auditing, Stakeholder Management, Strategic Planning, Regulatory Compliance, Ncqa Accreditation, Risk Assessment, Benchmarking, Performance Management, Business Planning, Technical Research, Financial Reporting, Managed Care Operations
Specialization
Requires a Bachelor's degree in Business or Accounting and at least 8 years of healthcare experience in quality review or auditing, including 5 years in management. Experience with NCQA accreditation and regulatory requirements for Medicare and Medicaid is essential.
Experience Required
Minimum 10 year(s)
OnCore Analyst Sponsored Research, Enterprises at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Oncore, Clinical Trial Management System, Application Design, System Integration, Data Quality Control, Technical Support, Cross Team Collaboration, Data Entry, Query Resolution, Software Implementation
Specialization
A bachelor's degree in a related field or equivalent experience is required, with a preference for experience in clinical research. Candidates should possess strong organizational skills and experience with CTMS or financial data systems.
Experience Required
Minimum 2 year(s)
Respiratory Therapist at UPMC
Everett, Pennsylvania, United States - Full Time
Skills Needed
Arterial Blood Gas Measurement, Mechanical Ventilation, Pulmonary Function Testing, Bronchopulmonary Drainage, Patient Assessment, Aerosol Therapy, Emergency Response, Clinical Data Interpretation, Patient Monitoring, Equipment Calibration
Specialization
Candidates must be graduates of a CoARC approved program and hold an RRT credential from the NBRC. Required certifications include a Respiratory Care Practitioner (RCP) license and BLS/CPR certification.
Electrical Journeyman at Accelevation
Atlanta, Georgia, United States - Full Time
Skills Needed
Electrical Installation, Electrical Maintenance, Troubleshooting, Blueprint Reading, Technical Drawing Interpretation, Conduit Bending, Cable Cutting, Compression Tools, Mechanical Lift Operation, Safety Compliance, Mentoring Apprentices, Emergency Response
Specialization
Requires a valid Journeyman Electrician License, a high school diploma, and at least 4 years of experience as an electrician. Proficiency with electrical tools and the ability to operate mechanical lifts are essential.
Experience Required
Minimum 2 year(s)
1st Shift Janitorial Office/Warehouse at SERVICEMAX INC
Anderson, South Carolina, United States - Full Time
Skills Needed
Cleaning, Sanitizing, Dusting, Sweeping, Mopping, Polishing, Scrubbing, Waste Management
Specialization
Candidates must be reliable, physically capable of standing for the entire shift, and able to work independently. No specific education or prior experience is listed as a requirement.
RN PRN Dialysis at Community Health System
Powell, Tennessee, United States - Full Time
Skills Needed
Patient Assessment, Medication Administration, Dialysis Machine Operation, Infection Control, Care Planning, Patient Education, Emergency Response, Clinical Documentation, Vital Signs Monitoring, Interdisciplinary Collaboration, Hemodynamic Monitoring, Patient Advocacy
Specialization
Candidates must have a valid Registered Nurse state license and BCLS certification, with ACLS, PALS, or NRP preferred. A minimum of 0-2 years of clinical nursing experience or acute care student rotations is required.
Event Coordinator (Weekends Only) at Nashville Shores
Nashville, Tennessee, United States - Full Time
Skills Needed
Event Coordination, Client Communication, Vendor Coordination, Multi Tasking, Interpersonal Skills, Oral Communication, Microsoft Office, Photoshop, Canva, Analytical Skills, Organization
Specialization
Candidates must be at least 18 years old and capable of lifting 25 to 30 pounds. Proficiency in Microsoft Office is required, with knowledge of Photoshop and Canva preferred.
Host - Canton at Trillium
Canton, Massachusetts, United States - Full Time
Skills Needed
Guest Service, Reservation Management, Communication, Multitasking, Organization, Attention To Detail, Teamwork, Time Management
Specialization
Candidates must be at least 18 years old and obtain TIPS training by their start date. Previous experience in a fast-paced restaurant setting is preferred along with the ability to perform physical tasks.
Physical Therapist at Alliance Residential Company
Tacoma, Washington, United States - Full Time
Skills Needed
Patient Evaluation, Evidence Based Practice, Patient Care Planning, Clinical Documentation, Patient Communication, Interdisciplinary Collaboration, Patient Mobility Assistance, Mentorship
Specialization
Must be a licensed or license-eligible Physical Therapist with a commitment to patient-first care. Candidates should possess a compassionate mindset and a desire for professional growth within a supportive team.
Assistant Director Childcare at LLE Education Group
Woodbridge, Virginia, United States - Full Time
Skills Needed
Leadership, Communication, Organization, Staff Management, Student Enrollment, Billing, Tuition Collection, Marketing, Public Relations, Bookkeeping, Parent Relations, Early Childhood Education
Specialization
Requires an early childhood professional credential or degree, at least one year of supervisory experience, and two years of teaching experience. Must complete Virginia Pre-Service Training and pass a background check.
Experience Required
Minimum 2 year(s)
CNC Machinist III at The Armor Group
Elkhart, Indiana, United States - Full Time
Skills Needed
Cnc Lathe Operation, Cnc Mill Operation, G Code Programming, Fixture Setup, Blueprint Reading, Precision Measuring Tools, Tool Offsets, Deburring, First Article Inspection, Work Coordinates, Microsoft Excel, Microsoft Access
Specialization
Requires a high school or vocational education with 4 years of relevant experience in CNC operation and G-code. Must be proficient with measuring tools, blueprint reading, and capable of lifting up to 65 pounds.
Experience Required
Minimum 2 year(s)
Sports Medicine Intern at UPMC
Pittsburgh, Pennsylvania, United States - Full Time
Skills Needed
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft Powerpoint, Administrative Support, Typing, Calendar Management, Office Equipment Operation, Data Entry, Customer Service
Specialization
A high school diploma is strongly preferred, and one year of administrative experience is highly desired. Proficiency in Microsoft Office Suite and the ability to use standard office equipment are required.
Science Teacher at ICAHN ENTERPRISES HOLDINGS LP
New York, New York, United States - Full Time
Skills Needed
Inquiry Based Instruction, Curriculum Alignment, Classroom Management, Student Assessment, Direct Instruction, Oral Communication, Written Communication, Collaborative Teaching
Specialization
Candidates must hold a Bachelor's degree and New York State certification in Science for grades 7-12. A Master's degree is preferred along with excellent communication skills.
Experience Required
Minimum 2 year(s)
Food & Beverage Coordinator at Icicle Brewing Co and Munchen Haus
Leavenworth, Washington, United States - Full Time
Skills Needed
Inventory Management, Kitchen Operations, Vendor Relations, Cost Control, Staff Scheduling, Budgeting, Food Safety Compliance, Recipe Development, Administrative Support, Team Leadership, Multi Tasking, Forecasting
Specialization
Candidates must have food and beverage experience, with supervisory experience in hospitality preferred. Required certifications include a Food Handlers Permit, Washington MAST Card, ServSafe Food Protection Manager, and Cicerone Certified Beer Server.
Experience Required
Minimum 2 year(s)
College Summer Intern at Aladdin Temp Rite
Hendersonville, Tennessee, United States - Full Time
Skills Needed
Design Engineering, Creative Marketing
Specialization
Applicants must be current college students or recent college graduates. The role is specifically for those interested in Design Engineering or Creative Marketing.
Resident Assistant at Flatrock
Washington Township, Ohio, United States - Full Time
Skills Needed
Personal Care, Medication Reminders, Mobility Support, Memory Care, Patient Monitoring, Interpersonal Communication, Cpr, First Aid
Specialization
Experience in memory care or assisted living is preferred, along with strong interpersonal skills and the ability to handle physical demands. Candidates should be reliable and patient, with CPR and First Aid certifications being a plus.
Phlebotomist - UPMC Carlisle at UPMC
Carlisle, Pennsylvania, United States - Full Time
Skills Needed
Phlebotomy, Venipuncture, Specimen Collection, Patient Identification, Medical Terminology, Laboratory Information Systems, Heelstick, Fingerstick, Arterial Puncture, Quality Control, Quality Assurance, Clerical Duties
Specialization
A high school diploma is required, while certification from an accredited Phlebotomy or Medical Assistant program and 6 months of experience are preferred. Candidates must obtain necessary clearances including FBI and Child Abuse reporting.
Telephone Operator - UPMC East at UPMC
Monroeville, Pennsylvania, United States - Full Time
Skills Needed
Telephone Operation, Customer Service, Emergency Coordination, Data Entry, Call Routing, Communication Skills, Multi Line Phone Systems, Detail Oriented
Specialization
Requires a high school diploma or equivalent and one year of experience in customer service or automated phone systems. Candidates must be available to work rotating shifts, including days, evenings, overnights, weekends, and holidays.
Community Manager at PTLA Real Estate Group
Hayward, California, United States - Full Time
Skills Needed
Leasing, Resident Relations, Marketing, Maintenance Management, Vendor Relations, Financial Reporting, Customer Service, Problem Solving, Fair Housing Compliance, Entrata, Spanish Bilingualism
Specialization
Requires a minimum of 2 years of property management and leasing experience and bilingual proficiency in Spanish. Candidates must have reliable transportation and be willing to live onsite at a designated property.
Experience Required
Minimum 2 year(s)