The RN Case Manager 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.
This opportunity is full time, 40 hours weekly, days, with a rotational need for weekends, holidays and call. At least three (3) years of RN work experience is required.
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
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
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, from senior management on down, 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.
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh FoodFarmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencingprograms, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 1...3 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers. What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.