RN - Registered Nurse Care Manager - Community Based
Case Management Society of America (CMSA) ®, Pittston, PA, United States
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.
Title
RN Care Manager
(Geisinger at Home)
Job Duties
You 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.
Typical schedule: (4) shifts 8 AM to 4:30 PM and (1) shift 10 AM to 6:30 PM.
Support home visits to patients in Luzerne County.
Rotation of weekends (approx. 1 weekend every 8 weeks) & holidays (approx. 1 holiday per year).
Work with physician and multidisciplinary team 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.
Coordinate efforts of other team members to satisfy patient and family needs.
Identify and resolve barriers that hinder effective patient 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.
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.
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 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.
Qualifications
Graduate from Specialty Training Program-Nursing (Required) or Bachelor's Degree in Healthcare Related Degree (Preferred).
Minimum of 3 years Nursing experience (Required).
Certification: Basic Life Support Certification (Default Issuing Body) and Licensed Registered Nurse (Pennsylvania) – RN_State of Pennsylvania.
Prior nursing experience in an Emergency Department, ICU or Home Health environment is preferred but not required.
EEO Statement
We are an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
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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.
Title
RN Care Manager
(Geisinger at Home)
Job Duties
You 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.
Typical schedule: (4) shifts 8 AM to 4:30 PM and (1) shift 10 AM to 6:30 PM.
Support home visits to patients in Luzerne County.
Rotation of weekends (approx. 1 weekend every 8 weeks) & holidays (approx. 1 holiday per year).
Work with physician and multidisciplinary team 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.
Coordinate efforts of other team members to satisfy patient and family needs.
Identify and resolve barriers that hinder effective patient 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.
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.
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 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.
Qualifications
Graduate from Specialty Training Program-Nursing (Required) or Bachelor's Degree in Healthcare Related Degree (Preferred).
Minimum of 3 years Nursing experience (Required).
Certification: Basic Life Support Certification (Default Issuing Body) and Licensed Registered Nurse (Pennsylvania) – RN_State of Pennsylvania.
Prior nursing experience in an Emergency Department, ICU or Home Health environment is preferred but not required.
EEO Statement
We are an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
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