Registered Nurse, Case Manager, Care Coordination
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Job Description
RN case manager coordinating patient-centered care for Geisinger Health Plan. Assessing needs, developing care plans, and optimizing clinical, quality, and fiscal outcomes.
Responsibilities:
- Assess, plan, implement, coordinate, monitor, and evaluate options and services to optimize patient or member health status
- Manage utilization and practice metrics to refine care delivery and maximize clinical, quality, and fiscal outcomes
- Integrate evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics into patient-centric treatment plans
- Develop systems of care that monitor progress and promote early intervention in acute care situations
- Assist with the design, implementation, and evaluation of the advanced patient-centered care model
- Assess healthcare, educational, and psychosocial needs of patients or members
- Design individualized plans of care and foster collaboration among patients or members, families, primary care providers, and healthcare teams
- Evaluate laboratory results, diagnostic tests, utilization patterns, and other metrics to monitor quality and efficiency
- Apply benefits and utilization management while serving as a resource to patients or members and healthcare teams
- Maintain required documentation for case management activities
- Collect required data and adjust treatment plans when indicated
Requirements:
- At least two (2) years of RN work experience
- Graduate from Specialty Training Program-Nursing (Required)
- Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
- Computer Literacy
- Critical Thinking
- Organizing
- Knowledge of healthcare laws, regulations, and insurance coverage policies is helpful
- Proficiency in healthcare IT systems and insurance claims processes is helpful
- Ability to work autonomously and as part of a multidisciplinary team is helpful
- Certified Case Manager / American Case Management Association (ACMA) is preferred
- BSN is preferred
- Case management experience is preferred
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 with a financial incentive
- Adoption and fertility assistance
- Parental leave pay
- Military leave pay
- Free Care.com membership with discounted backup care
- Employee Assistance Program (EAP), including childcare, eldercare, pet care, free legal guidance, mental health visits, work-life support, and digital self-help tools
- Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life, pet, and legal insurance
- Healthcare benefits for full-time and part-time positions from day one, including vision, dental, and domestic partners
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