Top 107 Complex care case manager Jobs in Pittsburgh Pa

Telephonic Care Manager (RN) - Adult Care Management
UPMC —Pittsburgh, PA
- $34.49 - $56.83 an hour
- Full-time
- Nursing
- RN License
- Computer literacy
Care Manager
Gwen's Girls —Pittsburgh, PA
- Weekends as needed
- Licensed Clinical Social Worker
- LPC
- Mid-level
Patient Support Specialist
ConnectiveRx —Pittsburgh, PA
- $15.26 - $19.00 an hour
- Full-time
- Spanish
- Writing skills
- English
- Paid holidays
- Disability insurance
Business Systems Analyst - Local to Cleveland, Miamisburg, Pittsburgh, or Dallas
CGI Group, Inc. —Pittsburgh, PA
- $89,600 - $156,700 a year
- Mid-level
- Office
- 3 years
- Paid parental leave
- Paid holidays
Case Manager
AccountStaff —Pittsburgh, PA
- $25 an hour
- Background check
- Spanish
- Nursing
Quick Apply
Adobe Workfront & Fusion Developer
CGI Group, Inc. —Pittsburgh, PA
- $58,800 - $196,700 a year
- Computer Science
- Office
- 3 years
- Paid parental leave
- Paid holidays
Medicaid Case Manager
Sechler Law Firm —Warrendale, PA
- $55,000 - $65,000 a year
- Evenings as needed
- Mid-level
- Driver's License
- Older adults
Quick Apply
5d
Care Manager (RN, Occupational Therapist, Social Worker)
Complete Care Strategies —Pittsburgh, PA
- $45 - $50 an hour
- Part-time
- Hybrid work
- Background check
- Nursing
- RN License
- Mileage reimbursement
- 401(k)
Quick Apply
10d
Social Work Case Manager
Heritage Valley Health System —Sewickley, PA
- Full-time
- Hospital
- Computer literacy
- Mid-level
Quick Apply
10d
LPN Case Manager
Allegheny County Pennsylvania —Allegheny County, PA
- $68,200 a year
- Online Application
- Background check
- Skilled nursing facility
- Computer literacy
Precert Care Manager (Evening Shift)
UPMC —Pittsburgh, PA
- $29.29 - $48.21 an hour
- Weekends as needed
- LMFT
- Nursing
- Microsoft Excel
- Employee assistance program
Reimbursement Case Manager
Vanscoy Rare Pharmacy —Coraopolis, PA
- Full-time
- Microsoft Outlook
- Ability to walk for extended periods
- Research
Quick Apply
9d
Aging Care Manager 3 (Local Government) Allegheny County Area Agency on Aging
Commonwealth of PA —Pittsburgh, PA
- $52,188 a year
- Full-time
- Hospital
- Mid-level
- Office
- Work from home
9d
Mobile Professional Care Manager - Beaver & Lawrence Counties
UPMC —Pittsburgh, PA
- $29.29 - $48.21 an hour
- Full-time
- LMFT
- Nursing
- RN License
Digital Product Management Senior Manager
PNC Financial Services Group —Pittsburgh, PA
- $50,000 - $274,840 a year
- Full-time
- 5 years
- Office
- Master's degree
- Wellness program
- Health savings account
Behavioral Health Absence Specialist
UPMC —Pittsburgh, PA
- $27.89 - $48.21 an hour
- Full-time
- LMFT
- Computer literacy
- Licensed Clinical Social Worker
RN Field Case Manager
Sedgwick —Canonsburg, PA
- Full-time
- Nursing
- RN License
- Mid-level
- Continuing education credits
- Health insurance
Nurse Clinical Care Coord-Allegheny County
UPMC —Pittsburgh, PA
- $34.49 - $56.83 an hour
- Full-time
- Nursing
- RN License
- Hospital
Executive Assistant
Boston Consulting Group —Pittsburgh, PA
- $71,000 - $79,667 a year
- Full-time
- Customer service
- Urgent Care
- Research
- Profit sharing
- Paid parental leave
Program Manager, HP OPD - Hybrid
UPMC —Pittsburgh, PA
- $47.28 - $81.63 an hour
- Full-time
- Hybrid work
- Office
- Master's degree
- Mentoring
- Health insurance

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Telephonic Care Manager (RN) - Adult Care Management

UPMC -
Pittsburgh, PA

Apply Now

Job Details

Full-time
$34.49 - $56.83 an hour

Qualifications

Collaborate with healthcare professionals
Computer operation
Managing patients as a nurse case manager
Computer skills

Full Job Description

Purpose:
Are you an experienced nurse looking for the next challenge in your career? Do you have knowledge of case management or care coordination? Check out this fantastic new opportunity!

UPMC Health Plan is hiring a full-time Telephonic Care Manager to support our Medical Management department based in our office located in Downtown Pittsburgh. This position will predominantly work standard daylight hours, Monday through Friday. The team is based out of downtown Pittsburgh's US Steel Tower, however, this position will predominantly work remotely.

The Telephonic Care Manager is responsible for care coordination and health education for identified adult Health Plan members through telephonic collaboration with members and their caregivers and providers. In this role, you will work to identify members' medical, behavioral, and social needs and barriers to care. You will develop a comprehensive care plan that assists members to close gaps in preventive care, address barriers to care, and support the member's self-management of chronic illness based on clinical standards of care. You will collaborate and facilitate care with other medical management staff, other departments, providers, community resources and caregivers to provide additional support. Our 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.
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

Apply Now

Refine Your Search

complex care case manager jobs in pittsburgh pa

Telephonic Care Manager (RN) - Adult Care Management

Care Manager

Patient Support Specialist

Business Systems Analyst - Local to Cleveland, Miamisburg, Pittsburgh, or Dallas

Case Manager

Adobe Workfront & Fusion Developer

Medicaid Case Manager

Care Manager (RN, Occupational Therapist, Social Worker)

Social Work Case Manager

LPN Case Manager

Precert Care Manager (Evening Shift)

Reimbursement Case Manager

Aging Care Manager 3 (Local Government) Allegheny County Area Agency on Aging

Mobile Professional Care Manager - Beaver & Lawrence Counties

Digital Product Management Senior Manager

Behavioral Health Absence Specialist

RN Field Case Manager

Nurse Clinical Care Coord-Allegheny County

Executive Assistant

Program Manager, HP OPD - Hybrid

I want to receive the latest job alert for complex care case manager in pittsburgh pa

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