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 care plans and systems of care for assigned patient populations
Domain
US Healthcare / Insurance Case Management
Required skills
RN licensure, care coordination, utilization management, evidence-based guideline integration, data collection and analysis, treatment plan design
Preferred skills
Certified Case Manager (ACMA), BSN, prior case management experience, knowledge of healthcare laws and insurance claims processes
Technologies
Healthcare IT systems, insurance claims platforms
Responsibilities
Assess healthcare, educational, and psychosocial needs of patients; design and implement individualized care plans; monitor quality and efficiency metrics; coordinate services with multidisciplinary teams; maintain case management documentation; apply benefits and utilization management resources.
Seniority
Mid-level, hands-on IC