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AmeriHealth Caritas Service Coordinator-CHC - Allegheny County in Pittsburgh, Pennsylvania

Service Coordinator-CHC - Allegheny County

Location: Pittsburgh, PA

Primary Job Function: Medical Management

ID**: 37965

This is a remote, field-based role requiring travel within Allegheny County.

AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team. Ideal candidates will have experience assessing those needing personal care services for instrumental daily living activities such as eating, bathing, dressing, preparing meals, managing medication, and housekeeping.

AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs.

We'd like to hear from you if you want to make a difference in people’s lives.

About this role:

As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing telephonic and face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support.

In this role, you will have the opportunity to:

  • Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.

  • Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation.

  • Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options.

  • Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process.

  • Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP.

  • Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements.

  • Works with the participant to complete activities necessary to maintain eligibility.

Qualified Applicants Will Have:

  • 3+ years of social service or related healthcare experience that required the following:

  • working with people who need personal care services,

  • conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services,

  • knowledge of the home and community-based service system and how to access/arrange for services,

  • maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests.

  • Valid and current driver’s license

  • Access to reliable automobile transportation with state-mandated minimum insurance.

  • Ability to travel up to 90 minutes from your home.

  • Must be computer proficient and have a working knowledge of MS Office.

  • Bachelor’s Degree in social work, psychology, or related field is preferred.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We implement these principles daily by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more.

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EOE Minorities/Females/Protected Veterans/Disabled

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