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Case Manager Registered Nurse

4 months ago

Danville, United States Geisinger Full time

Location:

Geisinger South Wilkes-Barre (GSWB)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

Yes

Job Summary:

The Special Needs Unit RN Case Manager at Geisinger Health Plan 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.

Job Duties:

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. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details:

This is an embedded clinic position and will be based in Luzerne County , PA. The Geisinger Health Plan Special Needs Unit supports pediatric patients and their families by providing care planning for complex healthcare-related matters and conditions. Our special needs team works with hospitals, specialists, pharmacists, and other health providers to provide the best care possible.

Hours: 8 AM to 4:30 PM Travel : Travel to perform home visits and hospital visits is required and will be reviewed during an interview. Limited travel for meetings and educational training. Required experience: 3 years of RN work experience Preferred experience: Pediatric experience strongly preferred. On-call : Limited. Will be reviewed during an interview. Department: Geisinger Health Plan

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Geisinger cares about not only its patients and members, but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally. We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. To learn more:

Our benefits package includes:

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

Education:

Graduate from Specialty Training Program-Nursing (Required), Bachelor's Degree-Nursing (Preferred)

Experience:

Minimum of 3 years-Nursing (Required)

Certification(s) and License(s):

Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania

Skills:

Computer Literacy, Critical Thinking, Organizing

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION : We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. 

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.