RN - Registered Nurse Care Manager - Community Based

About the role

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.

Responsibilities

• Work with physician and multidisciplinary team members to develop plan of care for each assigned patient from admission through discharge.
• Ensure patient is progressing toward 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.
• Identify and resolve barriers that hinder effective patient care.
• Work in conjunction with physicians, nurses, interdisciplinary team, and others to assess, plan, and initiate patient plan of care.
• Facilitate and coordinate details of the actual discharge to appropriate agencies.
• Facilitate and coordinate an individualized care coordination plan.
• Serve as a resource to physician and hospital personnel regarding available agency, facility, and community services to assist in discharge planning.
• Complete appropriate federal, state, and local forms.
• Ensure 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 entering data as requested and appropriate for role to support quality improvement initiatives into appropriate system.
• Conduct ongoing case review for delays or variances in care; raise issues with appropriate department, attending physician, and physician designee.
• Capture data per department policy.
• Communicate to appropriate physician identified issues for resolution and intervention.
• Use approved medical necessity criteria as a tool to ensure that patients meet appropriateness of the setting.
• Actively involve payer liaison role in any case that has potential of not meeting medical necessity guidelines.
• Support payer liaison role to resolve barriers through appropriate administrative and medical channels to avoid third-party payer denials.
• Maintain awareness of all concurrent denials through interaction with payer liaison.
• Work with payer liaison to facilitate timely discharge or alternative plan of care acceptable to physician, family, and payer.

Requirements

• Minimum of 3 years of nursing experience.
• Prior RN experience within an ED, ICU, and/or Case Management.
• Graduate from Specialty Training Program—Nursing.
• Licensed Registered Nurse (Pennsylvania) — RN_State of Pennsylvania.

Schedule

A typical schedule is Monday through Friday, 8:00 am to 4:30 pm with one late day working 10 am to 6:30 pm. Rotating weekends and holidays.

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 accrual of time quickly.
• Up to $5,000 in tuition reimbursement per calendar year.
• MyHealth Rewards wellness program to improve 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 loved ones.
• Employee Assistance Program (EAP): referrals for childcare, eldercare, and pet care; access to 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.