RN - Registered Nurse - Case Manager - GHP
Core
RN Case Manager coordinating patient-centered care, optimizing health status, and managing utilization for Geisinger Health Plan members.
Role type
Senior IC Registered Nurse Case Manager
Builds
Individualized plans of care and systems of care for assigned patient populations
Domain
US Healthcare / Health Insurance / Utilization Management
Required skills
Patient assessment, care coordination, utilization management, evidence-based clinical guidelines application, data collection and analysis, regulatory compliance
Preferred skills
Certified Case Manager (ACMA), BSN, case management experience, healthcare IT proficiency
Technologies
Healthcare IT systems, insurance claims processes
Responsibilities
Assess healthcare, educational, and psychosocial needs of patients; Design individualized plans of care; Monitor quality and efficiency metrics; Apply benefits and utilization management; Maintain case management documentation; Collaborate with multidisciplinary teams.
Seniority
Mid-level, hands-on IC