Case Manager, Registered Nurse – Field - Geisinger Community Medical Center, PA

• Serve as a liaison between members/clients, families, employers, providers, insurance carriers, and healthcare personnel as appropriate.

• Implement and coordinate case management activities for catastrophic and chronically ill members across the continuum of care, including consultant referrals, home care, community resources, and alternative levels of care.

• Interact with members/clients both telephonically and in person while working on‑site at Geisinger Community Medical Center, including meeting with members during inpatient admissions.

• Assess medical, functional, and vocational status to develop and implement individualized plans of care that support optimal health outcomes, benefits eligibility, and timely return to work or baseline functioning.

• Communicate effectively with stakeholders including medical providers, attorneys, employers, and insurance carriers.

• Prepare timely and accurate documentation of all case management activities.

• Collaborate with internal multidisciplinary teams to support optimal member outcomes.

• Conduct outreach to treating physicians and specialists to support appropriate care planning.

• Provide education and preventive guidance to promote best clinical outcomes.

• Apply applicable laws, regulations, and payer requirements related to rehabilitation and case management services.

• Monitor member progress toward desired outcomes and adjust care plans as needed.

• Develop proactive strategies to address complex needs and support both short‑ and long‑term wellness outcomes.

Required Qualifications

• Candidate must have active and unrestricted Registered Nurse (RN) License in the state of Pennsylvania (PA)

• 3+ years of clinical experience, preferably with Medicare and Commercial populations

• Ability to work independently within a hospital‑based environment

• Strong analytical, problem‑solving, organizational, and communication skills

• Proficiency in Microsoft Word, Excel, Outlook, PowerPoint, and proprietary clinical systems

• Efficient computer skills, including navigating multiple systems and keyboarding

• Reliable transportation and the ability to consistently meet onsite, hospital‑ based‑ work requirements at Geisinger Community Medical Center

Preferred Qualifications

• 3+ year of experience in care management, discharge planning, home health coordination, or utilization management

• Willingness to obtain multi‑state Registered Nurse (RN) licensure

• National certification (CRC, CDMS, CRRN, COHN, or CCM)

Education

• Associate’s Degree with equivalent clinical experience (REQUIRED)
• Bachelor's Degree (PREFERRED)