Work Type: FULL TIME (1.0 FTE); 80 hrs within a two week pay period.
The RN Care Manager, as part of an interdisciplinary team, including the patient/family, physicians, nurses, therapists and payors ensures that the patients progress in the acute episode of care through post discharge and is quality driven while being efficient and cost effective.
The incumbent interacts with patients, family members, healthcare professionals, and community and state agencies in this effort. The RN Care Manager serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information.
The RN Care Manager identifies high risk patients from a psychosocial/financial perspective, assesses the psychological needs of patients and families and provides information, support, counseling, care management, and referrals to appropriate resources.
The RN Care Manager works collaboratively with the interdisciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum. The expertise of the RN Care Manager is sought to resolve psychosocial patient care issues and to develop and implement a complex patient transition/discharge plan.
The RN Care Manager performs duties and tasks in accordance with performance standards established for the job. Practices within the patient safety guidelines. In addition, the RN Care Manager conducts all job responsibilities according to the Mission and Values of the organization.
Responsible for ensuring the very best patient/family experience by optimizing all customer interaction. Foster a positive work environment through mutual support and cooperation and adheres to GHS and unit specific Service Standards.
Reports to the Director of Care Management or Designee
MAJOR DUTIES AND RESPONSIBILITIES:
1. Works in conjunction with Interdisciplinary Team and others to assess, plan and initiate patient plan of care.
*2. Facilitates and coordinates details of placement and actual discharge to appropriate agencies.
*3. Works with Health Care team including but not limited to Social Worker, Nursing, and Physician Partners to complete appropriate Federal, State and Local Forms. a. Initiates and/or monitors completeness, accuracy and timeliness of all documentation, as required.
*4. Ensures adherence to Quality Standards. a. Participates in departmental and hospital performance improvement, quality programs, as directed. b. Provides documentation of initial assessments, on-going writing of progress notes and reviewing of all referrals for accuracy and content prior to discharge. c. Accepts responsibility for further development of professional learning and growth.
*7. Medical Record Review: a. Reports potential risk or quality management issues in appropriate computer software program
*8. Reporting: a. Escalates issues to appropriate resource as necessary to resolve barriers through appropriate administrative and medical channels.
9. Computer Skills: a. Demonstrates competency in accessing and documenting in electronic systems.
10. Professional Development: a. Adheres to patient bill of rights, State Board of Nursing Regulations and professional responsibilities outlined by ACMA. b. Assumes responsibility for own professional growth and on-going education. c. Demonstrates knowledge and compliance with all state and federal regulatory bodies, including but not limited to: (e.g., Joint Commission, DPW, CMS, Private insurance, QIO, Department of Aging) pertaining to discharge planning. d. Actively identifies opportunities for process improvement. f. Assumes additional responsibilities as delegated by the Director of Care Management or Designee.
12. Serves on committees as appropriate a. Identify and Participates in performance improvement or quality activities, as assigned. b. Performs other duties as assigned
*Denotes essential job duties
SPECIFIC POSITION DUTIES:
COMPETENCIES AND SKILLS:
Demonstrates knowledge of payor practices and regulatory mandates.
Demonstrates exceptional ability to retrieve clinical information from medical chart/documentation.
Demonstrates working knowledge of third party payers and pre-certification process.
Demonstrates the ability to review medical clinical documentation for sustained periods of time with high level of concentration.
Demonstrates the ability to collaborate with other members of the healthcare team and providers in a positive, professional, progressive and assertive manner.
Demonstrates excellent written and oral communication skills.
Demonstrates computer literacy.
EDUCATION AND/OR EXPERIENCE:
Registered Nurse with a valid unrestricted license or eligible for licensure in the state of Pennsylvania required BSN Required or enrolled in program within 6 months of hire and degree obtained within 4 years ACM within 2 years of eligibility or current CCM 3 years of clinical RN experience
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in a clinical or patient setting HOURS OF WORK May require ON – CALL Weekends and Holiday Rotation
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
Geisinger Health System is an integrated health services organization widely recognized for its innovative use of the electronic health record and the development of innovative care delivery models such as ProvenHealth Navigator® and ProvenCare®. As one of the nation’s largest health service organizations, Geisinger serves more than 3 million residents throughout 45counties in central, south-central and northeast Pennsylvania, and also in southern New Jersey with the addition of AtlantiCare, a National Malcolm Baldridge Award recipient. The physician-led system is comprised of approximately 30,000 employees,including nearly 1,600 employed physicians, 12 hospital campuses, two research centers and a 510,000-member health plan, all of which leverage an estimated $8.9 billion positive impact on the Pennsylvania economy. Geisinger hasrepeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit www.geisinger.org, or follow the latest Geisinger news and more on Twitter and Facebook.
** Does not qualify for J-1 waiver. 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.
Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family. Geisinger is nationally recognized for innovative practices and quality care. A mature electronic health record connects a comprehensive network of 13 hospital campuses, two research centers and nearly 1,600 Geisinger primary and specialty care physicians.Geisinger is an integrated health services organization widely recognized for its innovative use of the electronic health record and the development of innovative care delivery models such as ProvenHealth Navigator®, ProvenCare® and ProvenExperience®. As one of the nation’s largest health service organizations, Geisinger serves more than 3 million residents throughout 45 counties in central, south-central and northeast Pennsylvania, and also in southern New Jersey at AtlantiCare, a Malcolm Baldrige National Quality Award recipient. In 2017, the Geisinger Commonwealth School of Medicine and Geisinger Je...rsey Shore Hospital became the newest members of the Geisinger Family. The physician-led system is comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan, all of which leverage an estimated $12.7 billion positive impact on the Pennsylvania and New Jersey economies. Geisinger has repeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.