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RN - Registered Nurse Care Manager - Community Based

Job Summary

At Geisinger, you’ll find a supportive work culture, a comprehensive benefits package and now a newly enhanced pay structure – making it the perfect time to advance your careers with us.

Job Duties

You as an RN Care Manager within Geisinger at Home will play a vital role in delivering patient-centered care to Geisinger Health Plan’s most complex members in a home-based setting. You'll work collaboratively with physicians, nurses, and an interdisciplinary care team to assess, plan, and implement individualized care plans that promote optimal health outcomes.

• Luzerne County will be your primary territory but may need to cover other areas as needed.

• Company car will be provided.

• Your typical schedule will be (4) shifts: 8 AM to 4:30 PM and (1) shift: 10 AM to 6:30 PM

• This role will be to support home visits to patients in Luzerne County.

• Rotation of weekends (approx. 1 weekend every 8 weeks) & holidays (approx. 1 holiday per year).  Don’t worry, we’ll fully review this at your interview.

• At least (3) years of RN work experience is required.

• Prior nursing experience in an Emergency Department, ICU or Home Health environment is preferred but not required.

To learn more about Geisinger at Home, please visit:  https://www.geisinger.org/athome

Benefits of Working at Geisinger:

• 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.

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.

RN - Registered Nurse Care Manager - Geisinger at Home - Community Based

• 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.

(This specific position is home/community based.) 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.

Responsibilities