RN - Registered Nurse Care Manager - Community Based

Geisinger • Lewistown, PA

6d • Hybrid

About The Position

Join a team dedicated to transforming lives by providing personalized care coordination for patients in our community. Through professional growth, quality improvement, and interdisciplinary collaboration, we’ve built an innovative culture that allows nurses to grow their skillsets, develop their practice, and leverage their years of experience to build a rewarding, lasting career with impact. Our Geisinger nurses make a difference in the lives of the people they see every day- our friends, neighbors, and family members. As a Community-Based RN Care Manager with Geisinger at Home, you'll serve as a trusted advocate for patients navigating healthcare needs. Working closely with physicians, caregivers, and interdisciplinary teams, you'll develop personalized care plans, coordinate resources, and guide patients through their healthcare journey.

Requirements

• At least three (3) years of RN work experience is required.
• Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
• Graduate from Specialty Training Program-Nursing (Required)
• Minimum of 3 years-Nursing (Required)

Nice To Haves

• Prior RN experience within an ED, ICU and/or Case Management.

Responsibilities

• Works with physician and multidisciplinary team members to develop plan of care for each assigned patient from admission through discharge.
• Ensure patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and evaluations.
• Assess and respond to patient and family needs by coordinating efforts of other team members.
• Identifies and resolves barriers that hinder effective patient care.
• Works in conjunction with physicians, nurses, inter disciplinary team and others to assess, plan and initiate patient plan of care.
• Facilitates and coordinates details of the actual discharge to appropriate agencies.
• Facilitates and coordinates an individualized care coordination plan.
• Serves as a resource to physician and hospital personnel regarding available agency, facility, and community services to assist in discharge planning.
• Completes appropriate federal, state and local forms.
• Ensures adherence to quality standards and participation in quality monitoring and improvement by monitoring quality of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through defined processes, and enters data as requested and appropriate for role, to support quality improvement initiatives into appropriate system.
• Conducts on-going case review for delays or variances in care; raises issues with appropriate department, attending physician and physician designee.
• Captures data per department policy.
• Communicates to appropriate physician identified issues for resolution and intervention.
• Uses approved medical necessity criteria as a tool to ensure that patients meet appropriateness of the setting.
• Actively involves payer liaison role in any case that has potential of not meeting medical necessity guidelines.
• Supports payer liaison role to resolve barriers through appropriate administrative and medical channels to avoid third party payer denials.
• Maintains awareness of all concurrent denials through interaction with payer liaison.
• Works with payer liaison to facilitate timely discharge or alternative plan of care acceptable to physician, family and payer.
• Work is typically performed in a clinical and office environment.
• Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.

Benefits

• 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 to improve your health while earning a financial incentive
• Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
• Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.
• Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance.
• healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.
• atmosphere of collaboration, cooperation and collegiality.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree