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. 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.
Graduate from Specialty Training Program-Nursing (Required), Bachelor's Degree-Business Administration/Management (Preferred)
Minimum of 3 years-Related work experience (Required)
Certification(s) and License(s)
Basic Life Support Certification - American Heart Association (AHA); Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
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 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.
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Evaluation of Information Protection Practices -- Periodically, our operations and business practices are reviewed for compliance with organization policies and procedures governing the security, confidentiality and quality of our information.
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What About Legally Compelled Disclosure of Information?
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