Geisinger Health System - Lairdsville, PA
posted 3 months ago
The RN - Registered Nurse Care Manager at Geisinger at Home plays a crucial role in the healthcare team, working closely with physicians and multidisciplinary team members to develop and implement individualized care plans for patients from admission through discharge. This position is community-based, requiring travel to patients' homes primarily within Columbia and Montour Counties, with occasional travel to Danville for meetings and coverage in surrounding areas. The RN Care Manager is responsible for continuously monitoring patient care, ensuring that patients are progressing towards their desired health outcomes through regular assessments and evaluations. In this role, the RN will assess and respond to the needs of patients and their families, coordinating the efforts of other team members to address any barriers that may hinder effective patient care. The RN will facilitate and coordinate discharge planning, ensuring that patients are transitioned smoothly to appropriate agencies and services. This includes serving as a resource for physicians and hospital personnel regarding available community services and completing necessary federal, state, and local forms. The RN Care Manager will also be involved in quality monitoring and improvement initiatives, using predetermined criteria to assess the quality of care provided and reporting any potential risks or quality management issues. They will conduct ongoing case reviews to identify delays or variances in care and communicate these issues to the appropriate departments and physicians for resolution. The position requires a strong understanding of medical necessity criteria and the ability to work with payer liaisons to resolve any barriers to care, ensuring timely discharges and appropriate care plans are in place. The typical work hours for this position are from 8:30 AM to 5:00 PM, with one later day from 10:00 AM to 6:30 PM, and the RN may be required to participate in a weekend/holiday/on-call rotation, typically once a month or less. The RN will be accountable for adhering to all organizational policies and procedures, ensuring that they meet the specific obligations of their role.