Registered Nurse

Job Summary

Geisinger Health Plan is making better health easier and more accessible. We are consistently ranked for outstanding care and coverage, not just by independent reviewers, but by our members, that tells you something. At Geisinger Health Plan, you’ll be pioneering, pairing our health plan with a network of primary care and specialty providers, hospitals and urgent and convenient care centers. And it's all to make better health easier for our community.

Job Duties

Join Geisinger Health Plan as an RN Case Manager and make a meaningful impact through patient-centered care coordination. In this rewarding role, you'll support our vision of making better health easier while working alongside a collaborative team that is invested in your success, growth, and ability to deliver exceptional outcomes.

In this RN Case Manager role you'll support our commercial population, helping members address their individual health needs while collaborating with internal teams to advance employer-focused population health strategies and initiatives.

• At least two (2) years of RN work experience is required.
• Case management experience and Certified Case Manager / American Case Management Association (ACMA) is preferred.
• BSN is preferred.
• Knowledge of healthcare laws, regulations, and insurance coverage policies, and proficiency in healthcare IT systems and insurance claims processes preferred.
• Ability to work autonomously and as part of a multidisciplinary team is helpful.
• Active compact RN license is a plus.
• A typical schedule is full-time, days.
• This role is Exempt/salaried.

Benefits of working at Geisinger:

• 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  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.

Position Details

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,…