Registered Nurse – Case Manager

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Evaluate, plan, implement, coordinate, monitor, and assess options and services to enhance patient or member health outcomes.

• Oversee utilization and practice metrics to improve care delivery while maximizing clinical, quality, and financial results.

• Incorporate evidence-based clinical guidelines, preventive protocols, and metrics into patient-focused treatment strategies.

• Establish care systems that track progress and encourage early intervention during acute care scenarios.

• Aid in the design, implementation, and assessment of the advanced patient-centered care framework.

• Evaluate the healthcare, educational, and psychosocial needs of patients or members.

• Create personalized care plans and promote collaboration among patients or members, families, primary care providers, and healthcare teams.

• Analyze laboratory results, diagnostic tests, utilization trends, and other metrics to ensure quality and efficiency.

• Implement benefits and utilization management while serving as a support resource for patients, members, and healthcare teams.

• Ensure proper documentation is maintained for case management tasks.

• Gather necessary data and utilize it to modify treatment plans as required.

⛳️ Requirements

• Minimum of two (2) years of RN work experience.

• Graduate from a Specialty Training Program-Nursing (Required).

• Licensed Registered Nurse (Pennsylvania) - RN, State of Pennsylvania.

• Certification as a Case Manager / American Case Management Association (ACMA) is preferred.

• Bachelor of Science in Nursing (BSN) is preferred.

• Experience in case management is preferred.

• Familiarity with healthcare laws, regulations, and insurance coverage policies is advantageous.

• Proficiency in healthcare IT systems and insurance claims processes is beneficial.

• Capability to work independently as well as collaboratively within a multidisciplinary team is helpful.

🏝️ Benefits

• Comprehensive benefits (health, dental, and vision) starting from day one.

• Three medical plan options available, including an expanded network for out-of-area employees and dependents.

• Pre-tax healthcare and dependent care flexible spending accounts (FSA).

• Health savings account (HSA).

• Company-sponsored life insurance.

• Coverage for short-term disability.

• Coverage for long-term disability.

• 401(k) plan with automatic contributions from Geisinger.

• Generous paid time off (PTO) policy.

• Up to $5,000 in tuition reimbursement per calendar year.

• MyHealth Rewards wellness program with financial incentives.

• Assistance for adoption and fertility.

• Paid parental leave.

• Paid military leave.

• Complimentary Care.com membership with discounted backup care services.

• Employee Assistance Program (EAP), offering childcare, eldercare, pet care referrals, free legal guidance, mental health visits, work-life support, and digital self-help tools.

• Optional accident insurance.

• Critical illness insurance.

• Hospital indemnity insurance.

• Identity theft protection.

• Universal life insurance.

• Pet insurance.

• Legal insurance.

• Healthcare benefits for both full-time and part-time roles available from day one, including vision, dental, and support for domestic partners.