Mobile Licensed Care Manager - Clearfield & Jefferson County (Hybrid)

at  UPMC

UPMC Community Care Behavioral Health is seeking a full-time Mobile Licensed Care Manager to support the Community Services team within the Commercial Special Needs Program (SNP) Department in Clearfield County and Jefferson County!
The Mobile Licensed Care Manager will work flexible hours in a hybrid work structure, with Monday-through-Friday hours or four 10-hour shifts available! This role could travel up to approximately 70% (depending on caseload) out in their assigned community, with the remainder of the Care Manager’s work completed remotely/from home!
Community Care Behavioral Health (CCBH) is committed to giving our neighbors the quality of life that they deserve. A proud part of the UPMC Insurance Services Division, CCBH provides members with the behavioral health treatment that they need for better health and a higher quality of life, including treatment for mental health conditions, drug or alcohol addiction, and developmental disabilities.
The Mobile Licensed Care Manager supports UPMC Health Plan members who require care coordination, meeting those members out in their community, places of residence, and/or facilities. This role conducts assessments that include behavioral, clinical, social, and environmental concerns or needs, and will coordinate programs and services and facilitate communication between the member’s physicians, physical and behavioral health clinicians, and community-based services.

• Conducts face-to-face member assessments by visiting the member in the member’s community, place of residence, or facility.
• Conducts on-site hospital coordination for discharge planning with facility staff, if needed.
• Coordinates with members’ physicians to ensure follow-up and coordination of care.
• Collaborates with providers and others in order to obtain initial assessment, treatment planning, and aftercare planning for members.
• Conducts member assessments identifying behavioral, clinical, social, and environmental concerns and needs.
• Facilitates linkages for members and families between primary care and behavioral health providers and other social service or provider agencies, as needed, to develop and coordinate service plans.
• Ensures that cases are managed, and documentation is within established timeframes in accordance with departmental standards.
• Participates in case conferences, interagency and provider treatment planning, and departmental meetings.
• Makes referrals and provides expertise regarding community and governmental agencies.
• Assesses members’ knowledge of their clinical condition and the need for further education.
• Implements appropriate clinical interventions to ensure optimal clinical and quality outcomes for members.
• Develops specific outreach plans for assigned members who do not maintain regular contact with their medical or behavioral health provider, as recommended, as this contributes to frequent crises, recidivism, and interference with maximum benefit from available care.
• Receives and responds to complex and crisis calls.
• Coordinates care and services across the continuum of care with case management, physicians, pharmacy, behavioral health, and other providers or health plan departments, as appropriate.
• Identifies barriers to care and develops specific integrated plans of care in collaboration with the member, family, provider, and UPMC Health Plan staff.
• Maintains contact with and refers members to community-based case management services, as appropriate.
• Identifies provider issues and recommendations for improvement.
• Demonstrates knowledge of clinical treatment, case management, and community resources.
• Pennsylvania Licensure in health or human services field AND Master’s Degree OR Licensed RN.
• Three years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management required.
• Five years of experience with community-based case management and behavioral health experience preferred.
• General knowledge of best practices in working with special needs populations in the public sector preferred.
• Detail-oriented with excellent organization skills required.
• High level of verbal and written communication skills required.
• Proficiency in Microsoft Office products is preferred and ability to learn new software applications required.
• Three years of experience in a managed care environment preferred.
• Experience with geriatric populations preferred.
• Certification in substance use disorders helpful.