Provides leadership and direction for population health services. Develops, implements, and evaluates strategic initiatives focused on complex case management including Proven Health Navigator (PHN) as well as Specialty Care based case management functions. Directs strategic development, growth, and relationship building with key stakeholders as well as value care systems that intersect with PHN. Establishes an integrated approach to population management utilizing clinical and financial data in program design, implementation, and evaluation. This role will be responsible for driving programmatic changes in a fast-paced environment.
Develops strategic plans for design and delivery of population management programs that optimize value of the health care system to effectively manage the illness burden of the population served.
Assures implementation of department priorities to establish and maintain department goals, objectives, and service standards.
Provides direct supervision and guidance staff.
Aligns staff training programs to meet the needs of changing health care trends.
Develops and implements a case management model for those Specialty Care high risk that optimizes quality, experience, and efficiency outcomes.
Collaborates to develop value-based insurance products.
Monitors Health Plan utilization measures and identifies key trends to highlight care management opportunities and design population management interventions to manage costs while improving quality and member satisfaction.
Implements new strategies that support the vertical build of PHN.
Works collaboratively in the design of patient-centered population management programs.
Serves as a resource to other departments related to population management.
Evaluates the effectiveness of population management functions.
Discerns content, manner, and timing of information sharing with sensitivity to individual and organizational concerns.
Work is typically performed in an office environment. Travel may be required. 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.
Experience and understanding of adult patient populations with complex medical conditions desired. Position requires approximately 50% travel within the Geisinger service area. Weekend and holiday on-call required.
Minimum of 5 years-Clinical (Required), Minimum of 1 year-Managerial/Supervisory (Required)
Certification(s) and License(s)
Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
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 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.
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.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh FoodFarmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencingprograms, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13... hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers. What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.