JOB TITLE: Case Manager, Registered Nurse Geisinger Health Plan
LOCATION: Scranton Mount Pleasant Clinic
DEPARTMENT: Special Needs Unit
WORK SCHEDULE: Days
WORK TYPE: Full Time
Works under the supervision of the Special Needs Coordinator and Director, Health Services, Health Choices.
The Special Needs Unit is a regionally based resource to the embedded and community based case managers, Health Managers, members, community agencies, and other health plan staff to address specific needs to the Medicaid population.
Serves in an expanded nursing role to collaborate with members, Primary Care Providers, community agencies, behavioral health, dental and other health plan employees to provide a model of care that ensures the delivery of quality, efficient, and cost-effective healthcare services. Assess plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the member s health status. 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 Medicaid population.
Assists with the management of utilization and practice metrics to further refine the delivery of care model to maximize clinical, quality, and fiscal outcomes for the Medicaid population.
COMPETENCIES AND SKILLS:
Demonstrates customer focused interpersonal skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, patients, and families with diverse opinions, values, and religious and cultural ideals.
Demonstrates ability to work autonomously and be directly accountable for practice.
Demonstrates ability to influence and negotiate individual and group decision-making.
Demonstrates ability to function effectively in a fluid, dynamic, and rapidly changing environment.
Demonstrates leadership qualities including time management, verbal and written communication skills, listening skills, problem solving and decision-making, priority setting, work delegation and work organization.
EDUCATION AND/OR EXPERIENCE:
RN license or eligible for licensure in the state of Pennsylvania required. Bachelor's degree in health care preferred. Case Manager Certification preferred, required within three years of position acceptance.
Positions may require adult and/or pediatric specific experience.
Three to five years experience in clinical nursing, case management, and managing patients required. Knowledge of the basic concepts and principles of managed care required.
Critical thinking skills and ability to analyze complex data sets required. General computer knowledge and capability to use computers required.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
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.
GEISINGER MEDICAL GROUP(GMG) consists of 43 community practice sites throughout our service area. These office locations provide primary and specialty care. In conjunction with Geisinger Health Plan, the Medical Groups staff offers their own unique version of medical home.
One of the nation’s most innovative health services organizations, Geisinger serves more than 1.5 million patients in Pennsylvania and New Jersey. The system includes 13 hospital campuses, a nearly 600,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. A physician-led organization, with approximately 32,000 employees and more than 1,800 employed physicians, Geisinger leverages an estimated $12.7 billion positive annual impact on the Pennsylvania and New Jersey economies. Repeatedly recognized nationally for integration, quality and service, Geisinger has a long-standing commitment to patient care, medical education, research and community service. For more information, visit geisinger.org or connect with us onFacebook, Instagram, LinkedInand Twitter.
** Does not qualify for J-1 waiver. 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.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, 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 sequencing
programs, 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 13 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.