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Case Manager RN , Complete Needs

Company: Geisinger
Location: Scranton
Posted on: September 14, 2018

Job Description:

JOB TITLE: Case Manager RN , Complete Needs

LOCATION: Geisinger Community Medical Center

DEPARTMENT: Geisinger Health Plan Care Coordination

WORK SCHEDULE: Days

WORK TYPE: Full Time

JOB SUMMARY:

Works under the supervision of the Regional Manager and Director, Case Management.

Serves in an expanded nursing role to collaborate with members and with the Specialty Providers and Primary Care Providers to provide a model of care that ensures the delivery of quality, efficient, and cost-effective healthcare services specifically related to high risk/high utilization complex needs patients. Assesses, plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the most complex member's health status. Provides bedside education and collaborates with the inpatient and outpatient case managers, health care providers, and other care team members as the patient transitions across the care continuum. Population of focus includes patients with case management need such as, high utilization and targeted complex conditions. 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 most complex members.

Develops systems of care that monitor members specifically related to highest risk complex conditions and promotes early intervention in acute care situations. Works effectively with other members of the health care team to optimize interventions.

Manages utilization and practice metrics to further refine the delivery of care model to maximize clinical, quality, and fiscal outcomes for the highest risk 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, written, and electronic 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.

Obtain Case Management Certification within 3 years.

Strong clinical experience in caring for populations of patients with complex, chronic conditions.

Three years' experience in clinical nursing, case management preferred. 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/clinical/patient home environment. Travel required.

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 HEALTH PLAN (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania and West Virginia. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.

About Geisinger: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of 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. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and 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.

Keywords: Geisinger, Scranton , Case Manager RN , Complete Needs, Executive , Scranton, Pennsylvania

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