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PCA Care Connectionsposted 3 months ago
$55,022 - $63,695/Yr
Full-time • Mid Level
Philadelphia, PA
Resume Match Score

About the position

PCA Care Connections is a NCQA accredited non-profit agency that currently provides two types of services: Service Coordinator for Community Health Choices (CHC) participants enrolled with Pennsylvania Health and Wellness and Nursing Home Transition Services for participants enrolled with Pennsylvania Health and Wellness or Keystone First. We currently serve participants throughout the Greater Philadelphia region, including Philadelphia, Delaware, Montgomery, Bucks and Chester counties. The mission of PCA Care Connections is to provide high quality, person-centered and cost effective Service Coordination for older adults and persons with disabilities in partnerships with managed care organizations and integrated health systems and practices. Our goals are to promote quality of life, independence, dignity, and optimal health and well-being.

Responsibilities

  • Conducts ongoing monitoring and analysis of quality standards and compliance indicators for service coordination in PCA CC.
  • Conducts MIS System record audits using standardized instruments and reports to assess accuracy and timeliness of SC activity, documentation, and compliance with quality metrics.
  • Actively participates in all aspects of maintaining the agency’s NCQA Long-Term Care and Supports Care Management accreditation.
  • Provides feedback from audits and makes recommendations in collaboration with PCA CC management to modify internal processes, enhance training, and/or address individual performance issues.
  • Serves as PCA CC Point Person for critical incidents for CHC-MCO and monitors critical incident compliance.
  • Assists with the development and review of policies, procedures, tools, and resources to support staff in meeting CHC-MCO and NCQA requirements.
  • Maintains productive relationship with stakeholders, agencies, and organizations.
  • Other duties as assigned.

Requirements

  • MSW or related degree
  • Minimum of 3-5 years of clinical and administrative experience in social services
  • Knowledge and experience in Continuous Quality Improvement

Nice-to-haves

  • High energy level; able to manage a variety of tasks simultaneously.
  • Well-developed interpersonal and communication skills.
  • Well-developed organizational and problem-solving skills.
  • High level of flexibility.
  • Strong computer skills including experience with Excel.
  • Able to function independently.

Benefits

  • Medical, prescription drug, vision, and dental coverage
  • Flexible spending plan (health and dependent care)
  • EAP, life insurance, short- and long-term disability insurance
  • Pre-tax commuting, and parking benefits
  • Annual paid time off and vacation are based depending on tenure.

Job Keywords

Hard Skills
  • Community Health
  • Health And Wellness Management
  • Long-Term Care
  • Managed Care
  • Medical Prescription
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Soft Skills
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