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. The Behavioral Health Coordinator is responsible for ensuring integration and coordination of activities between the CHC-MLTSS (Community Health Choices - Managed Long Term Support Services), BH-MCOs (Behavioral Health Managed Care Organizations) and, Behavioral health providers.
This person will represent UPMC in interactions with BH-MCOs to coordinate services across the continuum of care through a community-based approach to improve health outcomes of members served. This is a full time position working Monday through Friday daylight hours. This is a remote position, however due to geographical requirements candidates must be located in Pennsylvania!
Develop processes to coordinate behavioral healthcare between PCPs and BH Providers. Ensures members have access to any needed behavioral health services. Serves as a liaison for CHC MCO integration and BH-MCO collaborative issues and efforts.
Coordinate Participant care needs with BH Providers. Assists members in identifying and choosing willing and qualified providers. Participate in the identification of best practices for BH in a primary care setting.
Actively coordinates with other individuals and entities essential in the physical and behavioral care delivery to provide members with seamless coordination between physical, behavioral and support services. Collaborates with BH-MCOs to facilitate delivery of CHC-MCO covered behavioral health services to eligible members. Coordinate behavioral care with medically necessary services.
Be knowledgeable of the BH Managed Care Agreement requirements and coordinate with the BH-MCO to effectuate the requirements Determines and develops processes needed to ensure integration and efficiency between CHC and BH-MCOs. Bachelor's degree in Social Work, Psychology or other health related fields. 3-5 years of experience in behavioral health. Behavioral health managed care experience.
Cultural competency and the ability to provide informed advocacy. Ability to interact with physicians and other health care professionals in a professional manner required. Experience working with people with disabilities or seniors in need of LTSS preferred.
Knowledge of the home and community-based service system and how to access and arrange for services preferred. Licensure, Certifications, and Clearances: Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran