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 and achieve optimal clinical, quality, and financial results.

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

• Create care systems that track progress and encourage early intervention in acute situations.

• Support the design, implementation, and assessment of the advanced patient-centered care model.

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

• Develop personalized care plans and promote collaboration among patients or members, families, 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 resource for patients, members, and healthcare teams.

• Maintain necessary documentation for case management activities.

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

• Adhere to organizational policies, procedures, and job-specific responsibilities.

⛳️ Requirements

• A minimum of two (2) years of RN experience is required.

• At least 3 years of nursing experience is required.

• Graduation from a Specialty Training Program-Nursing is required.

• Must hold a licensed Registered Nurse (Pennsylvania).

• Certified Case Manager / American Case Management Association (ACMA) certification is preferred.

• BSN is preferred.

• Experience in case management is preferred.

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

• Proficient in healthcare IT systems and insurance claims processes is advantageous.

• Ability to work independently and collaboratively within a multidisciplinary team is beneficial.

• Capability to work from home in Pennsylvania.

• Full-time availability and a day-shift schedule are required.

🏝️ Benefits

• Comprehensive benefits (health, dental, and vision) commencing on the first day.

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

• Pre-tax savings plans, including healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA).

• Company-funded life insurance, short-term disability, and long-term disability coverage.

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

• Generous paid time off (PTO) plan allowing for rapid accrual of time.

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

• MyHealth Rewards wellness program offering a financial incentive.

• Assistance with adoption and fertility.

• Paid parental leave.

• Paid military leave.

• Free Care.com membership with discounted backup care options.

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

• Optional benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life, pet, and legal insurance.

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