Works under the supervision of the Special Needs Unit.
The Special Needs Unit is a regionally based resource for members, R.N. case managers, health care providers, community agencies, and other health plan staff to address complex member needs.
The Case Manager applies the processes of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the member’s behavioral health needs across the continuum in collaboration with care team members to ensure safe, quality and cost-effective care. Located in the primary care setting, serves in an expanded clinical role to collaborate with patients, Primary Care Providers, community agencies, behavioral health, and other health plan departments to provide a model of care to maximize member’s health status. Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the Medicaid, Medicare and Commercial populations.
Directly reports to the Manager, Behavioral Health.
COMPETENCIES AND SKILLS:
Demonstrates customer focused interpersonal skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, patients, and families with diverse opinions, values, and religious and cultural ideals.
Demonstrates ability to work autonomously and be directly accountable for practice.
Demonstrates ability to influence and negotiate individual and group decision-making.
Demonstrates ability to function effectively in a fluid, dynamic, and rapidly changing environment.
Demonstrates leadership qualities including time management, verbal and written communication skills, listening skills, problem solving and decision-making, priority setting, work delegation and work organization.
Demonstrates the ability to receive stimuli from multiple sources simultaneously
Demonstrates organization and delegation, negotiation and conflict resolution, and possesses the ability to be self-directed, flexible, and committed to the team concept.
Demonstrates teamwork, initiative and willingness to learn, accepts and respects diversity without judgment, and demonstrates strong customer service values.
Demonstrates excellent written, verbal, and listening communication skills, positive relationship building skills, and critical analysis skills into case management practice.
Demonstrates general computer knowledge and capability to use computers.
EDUCATION AND/OR EXPERIENCE:
· Master's Degree in Social Work (MSW) or Psychology (MS) from accredited school or program required
· LSW (Licensed Social Worker) LCSW (Licensed Clinical Social Worker), or LPC (Licensed Professional Counselor) with the Pennsylvania State Board preferred. Licensure required within 1 year of hire.
· Two (2) years of clinical social work experience or five (5) years of behavioral health work experience required.
· One (1) year experience in care coordination and care planning required.
· Experience with conducting home visits preferred.
· Experience functioning on a multi-disciplinary team preferred.
· Knowledge of the basic concepts and principles of managed care preferred.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
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.
GEISINGER HEALTH PLAN (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania and West Virginia. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.
About Geisinger: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of 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. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
** Does not qualify for J-1 waiver. 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.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, 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 sequencing
programs, 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.