Job Summary

Serves in an expanded nursing role to coordinate and provide disease management education and clinical management for plan members enrolled in Health Management programs. Collaborates with primary care providers in multiple practice sites to facilitate clinical guideline adherence and coordinate services specifically related to the member s health care needs.

Job Duties

• Assists leadership in the design, implementation and evaluation of health management programs to support overall the Health Plan goals and strategic business strategies.
• Receives referrals for health management, assures appropriateness of member referrals, and triages and stratifies members according to assessed needs for enrollment into Health Management programs.
• Utilizes established education pathways to direct comprehensive and consistent disease management education to members.
• Assesses physical, social, and functional status to direct education and management activities.
• Coordinates services and serves as a resource to members, families, and staff for all Health Management programs.
• Collaborates with primary care providers to enhance evidence-based clinical guideline adherence and promote best practice by initiating and adjusting therapies as directed by the practitioner and providing approprionitoring as needed.
• Facilitates and coordinates laboratory and diagnostic tests for all disease management programs.
• Continuously evaluates members progress toward desired health outcomes and adjusts plan of care for optimal outcomes.
• Markets the role and value of health management in disease management and case management to primary care providers, office staff and the community.
• Collects and documents data, analyzes and communicates results and documents as required for Health Management programs.
• Assesses health care needs for employer work groups and community sites, and provides appropriate health management programs.
• Collects, evaluates and documents interventions and outcomes for these programs according to Health Management standards.
• Utilizes Health Management outcomes to promote benefits and availability of disease and case management services with providers and other health care providers.
• Identifies problems, proposes process improvement strategies and assists the Care Coordination team in Quality Improvement activities.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details

Preferred Qualifications

• Certified Diabetes Educator Certification

Education

Graduate from Specialty Training Program-Nursing (Required), Bachelor's Degree-Nursing (Preferred)

Experience

Minimum of 3 years-Nursing (Required)

Certification(s) and License(s)

Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life Support Certification - Default Issuing Body

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.