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

Position Summary The ACC Case Manager applies a collaborative, member‑centered approach to assessment, care planning, coordination, evaluation, and advocacy to address the comprehensive health needs of individuals and families in a hospital‑based setting at Geisinger Community Medical Center. Responsibilities 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 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+ years 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). Hours & Compensation Anticipated weekly hours: 40. Time type: Full time. Pay range: $60,522.00 – $129,615.00. The position is eligible for a CVS Health bonus, commission, or short‑term incentive program in addition to the base pay range. Benefits The role is eligible for a comprehensive benefits package including medical, dental, vision, paid time off, retirement savings options, wellness programs, and other resources. EEO Statement Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr 4062 Aetna Resources, LLC