RN - Registered Nurse Care Manager - Community Based

Location:
Geisinger Health Plan Hughes Center

Shift:
Days (United States of America)

Scheduled Weekly Hours:
40

Worker Type:
Regular

Exemption Status:
No

Job Summary:
Our Geisinger nurses make a difference in the lives of the people they see every day - our friends, neighbors, and family members.

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.

Job Duties:

Geisinger at Home brings personalized healthcare directly to eligible Geisinger Gold Medicare Advantage members in the comfort of their homes. This community-based RN opportunity 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.

Qualifications

- At least 3 years of RN work experience required
- Experience in case management, critical care, emergency, or home healthcare is a plus

More than a job. Benefits designed for your life.

When you join Geisinger, you’ll have access to benefits designed to support your health, financial well-being, family and future, including:

- 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 FSAs and an HSA
- 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

Position Details:

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. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Education:
Graduate from Specialty Training Program-Nursing (Required), Bachelor's Degree-Nursing (Preferred)

Experience:
Minimum of 3 years-Nursing (Required)

Certification(s) and License(s):
Basic Life Support Certification - Default Issuing BodyDefault Issuing Body, Licensed Registered Nurse (Pennsylvania) - RN_State of PennsylvaniaRN_State of Pennsylvania

Skills:

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, we encourage an atmosphere of collaboration, cooperation and collegiality.

Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.