[Hiring] Registered Nurse - Case Manager @Geisinger

Role Description

Join Geisinger Health Plan as an RN Case Manager and make a meaningful impact through patient-centered care coordination. In this rewarding role, you'll support our vision of making better health easier while working alongside a collaborative team that is invested in your success, growth, and ability to deliver exceptional outcomes.

• Assesses, plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the patient or member's health status.
• Manages utilization and practice metrics to further refine the delivery of care model to maximize clinical, quality, and fiscal outcomes.
• Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the identified population.
• Develops systems of care that monitor progress and promote early intervention in acute care situations.
• Assists with the design, implementation, and evaluation of the advanced patient-centered care model.
• Assesses the healthcare, educational and psychosocial needs of patients or members.
• Designs an individualized plan of care and fosters a team approach by working collaboratively with the patient or member, family, primary care provider, and other members of the health care team to ensure coordination of services.
• Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
• Works to appropriately apply benefits and utilization management serving as a resource to the patient or member and healthcare team.
• Maintains required documentation for all case management activities.
• Collects required data and utilizes this data to adjust the treatment plan when indicated.
• Work is typically performed in a clinical environment.

Qualifications

• At least two (2) years of RN work experience is required.
• Certified Case Manager / American Case Management Association (ACMA) is preferred.
• BSN is preferred.
• Case management experience is preferred.
• Knowledge of healthcare laws, regulations, and insurance coverage policies, and proficiency in healthcare IT systems and insurance claims processes is helpful.
• Ability to work autonomously and as part of a multidisciplinary team is helpful.

Requirements

• Graduate from Specialty Training Program-Nursing (Required).
• Bachelor's Degree-Nursing (Preferred).
• Minimum of 2 years-Nursing (Required).
• Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania.

Benefits

• Full benefits (health, dental and vision) starting on day one.
• Three medical plan choices, including an expanded network for out-of-area employees and dependents.
• Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA).
• Company-paid life insurance, short-term disability, and long-term disability coverage.
• 401(k) plan that includes automatic Geisinger contributions.
• Generous paid time off (PTO) plan that allows you to accrue time quickly.
• Up to $5,000 in tuition reimbursement per calendar year.
• MyHealth Rewards wellness program to improve your health while earning a financial incentive.
• Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones.
• Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.
• Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance.