AmeriHealth Caritas Service Coordinator CHC Senior in Pittsburgh, Pennsylvania
Service Coordinator CHC Senior
Location: Pittsburgh, PA
Your career starts now. We’re looking for the next generation of health care leaders.
At AmeriHealth Caritas, we’re 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. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .
Describe the primary (most important) purpose of the job in no more than a paragraph to provide a solid overview of the essence of the job in seven sentences or less.
The CHC Senior Service Coordinator assists participants who are eligible for LTSS in obtaining the services they need as required by CHC. He or she contributes to the LTSS care coordination process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of participant’s needs, including physical health, behavioral health, social services and long term services and supports. This position is also responsible for conducting audits of external Service Coordination entities in accordance with the AmeriHealth Caritas Pennsylvania Community Health Choices model of care.
Key Accountabilities and Responsibilities
Conduct audits of external Service Coordination Entities in accordance with the AmeriHealth Caritas Pennsylvania Community Health Choices model of care.
Collaborates with corporate training team to facilitate in person training sessions with external service coordination entities
Facilitate participant-centered planning team meetings to coordinate care and services Identify, coordinate, and assist participants in gaining access to needed LTSS and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.
Provides information to participants and conducts monitoring of authorized services and supports for Participants.
Informs participants about available LTSS required needs assessments, the PCSP process, service alternatives and service delivery options.
Informs participants of their rights and responsibilities as well as assists with the complaint, grievance, and DHS Fair Hearing process.
Collects additional necessary information, including participant preferences, strengths, and goals to inform the development of the PCSP.
Conducts comprehensive needs assessments annually or more frequently as needed in accordance with CHC requirements.
3-5 years at least three years working in social service or health care related field.
Pennsylvania licensed RN or LCSW
Experience working with people with disabilities or seniors in need of LTSS
Knowledge of the home and community-based service system and how to access and arrange for services;
Experience conducting LTSS needs assessments and monitoring LTSS delivery.
Ability to provide informed advocacy
Ability to interact with health care professionals in a professional manner.
Ability to travel up to 75%
Valid driver’s license required
EOE Minorities/Females/Protected Veterans/Disabled