RN Care Manager - Care Coordination

Company: Geisinger
Location: Moosic
Posted on: November 22, 2021

Job Description:

Job Title: RN Care Manager - Care Coordination
Location: Scranton, Pennsylvania
Job Category: RN - Registered Nurse, Nursing and Nursing Support
Schedule: Days
Work Type: Full time
Department: GCMC Care Management Team
Date Posted: 10/14/2021
Job ID: R-20322
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.

Position Details
Work Schedule/Details:
8AM to 4:30PM
Rotation of weekends and holidays - will be reviewed at interview

We 're proud to offer competitive salaries and a comprehensive benefits package that includes :
Medical, prescription drug, vision and dental coverage
Family Support (Fertility and Adoption Support)
Employer contribution to your retirement plan
Tuition assistance (part time and full time roles only)
Generous paid time off packages that allows you to take the time you need to travel, rest, and care for and reconnect with friends and family.
Professional opportunities for growth and advancement
Support and mentorship from a full range of dedicated and experienced nursing leaders
Paid Military Leave
Community Involvement through our Employee Resources Groups

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; Basic Life Support Certification - Default Issuing Body
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 are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

Keywords: Geisinger, Scranton , RN Care Manager - Care Coordination, Executive , Moosic, Pennsylvania