Clinical Associate (Hybrid)

Location

Exton, PA | United States

Job description

UPMC Community Care Behavioral Health is seeking a full-time Clinical Associate to support the Chester County Care Management Department in Exton, PA!

The Clinical Associate will work daylight hours, Monday through Friday, in a hybrid work structure! This role will primarily be able to work from home, but there will be occasional office time in the Exton office. 

Community Care Behavioral Health (CCBH) is committed to giving our neighbors the quality of life that they deserve. A proud part of the UPMC Insurance Services Division, CCBH provides members with the behavioral health treatment that they need for better health and a higher quality of life, including treatment for mental health conditions, drug or alcohol addiction, and developmental disabilities.

The Clinical Associate will manage member service-related functions and specific care-related functions for member populations served by Community Care! This role serves as a resource and advocate for members in their interaction with all aspects of Community Care, and also works to ensure accurate information is documented and relayed to team members and providers. Supporting the Children’s Services team, the Clinical Associate is “the hub” of the team, responding to member questions, relaying information to providers, facilitating referrals, and supporting activities related to education, outreach, prevention, and clinical record review for members. 

The ideal candidate for this position will have previous clinical experience in a behavioral health setting, specifically working with children’s care. The Clinical Associate will work hand-in-hand with Care Managers, working to manage the implementation of procedural modifications, data entry of medical necessity records, the review of overall clinical data, and fostering a strong rapport with providers. Previous experience with care management is also preferred, while exceptional communication skills are vital to this role.

Responsibilities:

• Conducts outreach as well as assistance with coordination of care for members who do not maintain regular contact with their behavioral health provider as recommended.
• Provides members, providers, and other stakeholders with accurate information concerning benefits and coverage, including (but not limited to) information about the PH-MCO, IEAP, CART, etc.
• Coordinates, reviews, and maintains information for reporting purposes and analysis.
• Independently problem-solves based on knowledge of in-plan services, the provider network, member services policies, members’ rights and responsibilities, and the operating practices of the organization.
• Collects information regarding the delivery and outcomes of services to members.
• Works with members, providers, and the designated care manager to customize services to best meet members’ needs within the parameters of available services.
• May engage in the acquisition or transfer of structured clinical data, but does not engage in any activities that involve clinical evaluation or interpretation.
• Utilizes supervision on a regular basis.
• Works as an effective member of the care management department and individual team.
• Collects data for company initiatives in cooperation with the department of oversight, e.g., quality department, provider relations, etc. 
• Assumes responsibility for member’s access to in-plan and/or supplemental services as medically necessary.
• Maintains an understanding of behavioral health benefits and remains current on covered or in-plan services, benefit limitations, exclusions, and care management policies and procedures.
• Executes daily responsibilities with evidence of cultural competency and awareness of CSP, CAASP, and/or BDAP principals, as applicable.
• Identifies provider issues with recommendations for improvement.
• Consults with senior clinicians and/or immediate supervisor, as needed, in the fulfillment of daily responsibilities.
• Participates in CQI activities and provider training, and participates in professional development activities, as appropriate.
• Works independently in the community with provider agencies and members.

Job tags

Salary

$19.92 - $33.12 per hour