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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in case management, patient-centered care, and healthcare coordination, with a strong focus on optimizing clinical and fiscal outcomes through evidence-based practices and multidisciplinary collaboration.
Highest-signal resume keywords
Licensed Registered NurseCase Management ExperienceCertified Case ManagerHealthcare IT Systems ProficiencyCritical Thinking
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient-Centric Treatment PlansUtilization ManagementHealthcare AssessmentData Collection and AnalysisEvidence-Based Clinical GuidelinesAcute Care InterventionDocumentation for Case ManagementDiagnostic Test EvaluationCare Delivery OptimizationHealthcare Metrics Management
Soft Skills
OrganizingAutonomous WorkMultidisciplinary Team Collaboration
Tools & Technologies
Healthcare IT SystemsInsurance Claims Processes
Certifications & Qualifications
Licensed Registered Nurse (Pennsylvania)Certified Case ManagerSpecialty Training Program-Nursing
Industry Keywords
Healthcare LawsRegulationsInsurance Coverage PoliciesPopulation Health StrategiesPatient Needs Assessment
About the role
Key responsibilities & impact- Support the commercial population by helping members address individual health needs
- Collaborate with internal teams on employer-focused population health strategies and initiatives
- Assess, plan, implement, coordinate, monitor, and evaluate options and services to optimize patient or member health
- Manage utilization and practice metrics to refine care delivery and maximize clinical, quality, and fiscal outcomes
- Integrate evidence-based clinical guidelines, preventive guidelines, protocols, and metrics into patient-centric treatment plans
- Develop systems of care that monitor progress and promote early intervention in acute care situations
- Assist with the design, implementation, and evaluation of the advanced patient-centered care model
- Assess healthcare, educational, and psychosocial needs of patients or members
- Design individualized plans of care and coordinate services with patients, families, primary care providers, and healthcare teams
- Evaluate laboratory results, diagnostic tests, utilization patterns, and other metrics
- Apply benefits and utilization management while serving as a resource to patients, members, and healthcare teams
- Maintain documentation for case management activities
- Collect data and adjust treatment plans when indicated
Requirements
What you’ll need- At least two (2) years of RN work experience
- Graduate from Specialty Training Program-Nursing (Required)
- Licensed Registered Nurse (Pennsylvania) required
- Bachelor's Degree-Nursing preferred
- Case management experience preferred
- Certified Case Manager / American Case Management Association (ACMA) preferred
- Knowledge of healthcare laws, regulations, and insurance coverage policies preferred
- Proficiency in healthcare IT systems and insurance claims processes preferred
- Ability to work autonomously and as part of a multidisciplinary team helpful
- Active compact RN license a plus
- Computer literacy
- Critical thinking
- Organizing
Benefits
Comp & perks- Full benefits (health, dental and vision) starting on day one
- Three medical plan choices, including an expanded network for out-of-area employees and dependents
- Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA)
- Company-paid life insurance, short-term disability, and long-term disability coverage
- 401(k) plan that includes automatic Geisinger contributions
- Generous paid time off (PTO) plan that allows you to accrue time quickly
- Up to $5,000 in tuition reimbursement per calendar year
- MyHealth Rewards wellness program with a financial incentive
- Adoption and fertility assistance
- Parental leave pay
- Military leave pay
- Free Care.com membership with discounted backup care
- Employee Assistance Program (EAP), including childcare, eldercare, pet care referrals, free legal guidance, mental health visits, work-life support, and digital self-help tools
- Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life insurance, pet insurance, and legal insurance
- Healthcare benefits for full-time and part-time positions from day one, including vision, dental, and domestic partners