Mobile Professional Care Manager (RN) - Butler County

About the Role

The Mobile Professional Care Manager supports the Care Management Department in Butler County, working flexible hours Monday through Friday. This role is primarily community-based, with the majority of time spent traveling throughout Butler County to meet with members. The remainder of the work is completed remotely from home.

The Mobile Professional Care Manager assists UPMC Health Plan members requiring care coordination, conducting assessments that include behavioral, clinical, social, and environmental concerns or needs. Members will be followed in their community, place of residence, and in facilities. The role involves coordinating programs, services, and facilitating communication between the member's physicians, physical and behavioral health clinicians, and community-based services.

Responsibilities

• Conducts face-to-face member assessments by visiting members in their community, place of residence, or facility.
• Performs 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 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 to develop and coordinate service plans.
• Ensures cases are managed and documentation is completed 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.
• 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.

Requirements

• Pennsylvania Licensure in a health or human services field and master's degree OR licensed RN (BSN preferred) OR Paramedic/EMT with 6-8 years of experience.
• Preference given to candidates with a PA Licensure in a health or human services field and master's degree OR licensed RN.
• 3 years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management required.
• 5 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.
• 3 years of experience in a managed care environment preferred.
• Experience with the geriatric population preferred.
• Detail-oriented with excellent organization skills required.
• High level of oral and written communication skills required.
• Proficiency in Microsoft Office products preferred; ability to learn new software applications required.
• Certification in substance use disorders helpful.

Licensure, Certifications, and Clearances

• Clinical Social Work OR Licensed Social Worker OR Professional Counselor OR RN Licensed Mental/Behavioral Health Professional or RN license required.
• CPR required based on AHA standards that include both a didactic and skills demonstration component within 30 days of hire.
• Automotive Insurance.
• Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR).
• Clinical Social Worker (CSW) OR Emergency Medical Technician (EMT) OR Licensed Clinical Social Worker (LCSW) OR Licensed Marriage & Family Therapist OR Licensed Professional Counselor (LPC) OR Licensed Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse (RN).
• Driver's License.
• Act 33 with renewal.
• Act 34 with renewal.
• Act 73 FBI Clearance with renewal.
• 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 located will have 60 days upon changing their residency to apply for licensure within that state.

Schedule

Full-time, flexible hours Monday through Friday, with travel throughout Butler County.