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RN - Care Manager Registered Nurse - Care Coordination
1 month ago
Location: Scranton, Pennsylvania
Job Category: RN - Registered Nurse, Nursing and Nursing Support
Schedule: Days
Work Type: Full time
Department: GCMC Care Services Operations Team
Date Posted: 07/11/2024
Job ID: R-64532
Job Summary 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 andfamily needs by coordinating efforts of other team members. Identifies and resolves barriers that hinder effective patient care.
Job Duties
- 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 physicianidentified 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 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.
Hours: 8:00a-4:30p
Weekends: every 4th weekend
Holidays: Rotation
On-Call: None
Experience: 3 years RN work history is required
Union: Yes
Geisinger cares about not only its patients and members, but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally. We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. To learn more:
- 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
- Robust PTO plan in addition to six paid holidays and 32 hours of personal time per year
- 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 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
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) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
Our Purpose & Values 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, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be 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.
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