RN - Registered Nurse Care Manager - Community Based

Geisinger•Danville, PA

About The Position

Geisinger at Home delivers personalized healthcare in the homes of eligible Geisinger Gold Medicare Advantage members. This community-based RN role serves patients throughout Columbia, Montour, and Northumberland counties. The typical schedule is Monday through Friday, 8:00 AM to 4:30 PM, with one 10:00 AM to 6:30 PM shift each week, plus rotating weekends and holidays. The role works in a clinical and office environment and coordinates patient care from admission through discharge in collaboration with physicians and multidisciplinary team members. The Care Manager develops and facilitates individualized care coordination plans, monitors patients’ progress toward desired outcomes, responds to patient and family needs, and addresses barriers to effective care. The role coordinates discharge planning and connects patients with appropriate agencies, facilities, and community services. It also supports quality monitoring and improvement, reviews cases for care delays or variances, applies approved medical necessity criteria, and collaborates with payer liaisons to resolve barriers and prevent denials. Applicants must be graduates of a nursing specialty training program and have at least three years of nursing experience. A bachelor's degree in nursing is preferred. Required credentials include Basic Life Support certification and a Pennsylvania Registered Nurse license.

Requirements

Graduate from a nursing specialty training program.
At least 3 years of nursing experience.
Basic Life Support certification.
Licensed Registered Nurse in Pennsylvania.

Nice To Haves

Bachelor's degree in nursing.
Experience in case management, critical care, emergency care, or home healthcare.

Responsibilities

Work with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge.
Monitor patient care through ongoing assessments and evaluations to ensure progress toward desired outcomes.
Assess and respond to patient and family needs by coordinating the efforts of other team members.
Identify and resolve barriers that hinder effective patient care.
Assess, plan, and initiate patient care plans in conjunction with physicians, nurses, and interdisciplinary team members.
Facilitate and coordinate discharge to appropriate agencies and individualized care coordination plans.
Advise physicians and hospital personnel about agency, facility, and community services available to support discharge planning.
Complete appropriate federal, state, and local forms.
Monitor care quality using predetermined criteria, report potential risks and quality-management issues through defined processes, and enter data to support quality improvement initiatives.
Review cases for delays or variances in care and raise issues with the appropriate department, attending physician, or physician designee.
Capture data according to department policy and communicate issues to the appropriate physician for resolution and intervention.
Use approved medical necessity criteria to assess whether patients meet setting-appropriateness guidelines.
Involve and work with payer liaisons on cases with potential medical necessity issues, concurrent denials, and barriers to timely discharge or an acceptable alternative care plan.

Benefits

Medical, dental, and vision benefits starting day one.
Three medical plan options, including expanded coverage for out-of-area employees and dependents.
401(k) with automatic Geisinger contributions.
Generous paid time off.
Up to $5,000 annually in tuition reimbursement.
Company-paid life and disability insurance.
Healthcare and dependent care flexible spending accounts and a health savings account.
MyHealth Rewards wellness incentives.
Family-focused benefits, including adoption and fertility assistance, parental leave pay, military leave pay, and Care.com membership.
Employee Assistance Program resources for mental health, work-life needs, legal guidance, and caregiving support.
Optional coverage for accident, critical illness, hospital indemnity, identity theft, pet care, legal needs, and more.