Job Summary

Job Duties

A typical workweek is Monday through Friday, days.

At least three (3) years of prior RN experience is required. 

The ideal candidate will have prior RN experience in a hospital setting. Case Management experience is preferred and not required.

The successful candidate must be available to work on-site at GCMC.

Union: Yes

Benefits of working in Care Management

Strong team culture

Consistent scheduling

Meaningful mission-driven work

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

The Registered Nurse Care Manager 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 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.

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.

Education

Experience

Certification(s) and License(s)

Our Purpose & Values