Case Manager- Gen Med

Duke Careers•Durham, NC

About The Position

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of Duke Health's four hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Duke Nursing Highlights: Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility) Work Schedule: Gen Med Sat-Tuesday 4/10s Weekend Option External candidates eligible for a $7500.00 Commitment Bonus paid over 1 year The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care. This role supports optimal patient outcomes, effective resource utilization, and compliance with CMS and other regulatory agencies. The Case Manager collaborates closely with interdisciplinary teams, patients, families, and community partners to coordinate safe, efficient care transitions.

Requirements

Ability to work independently in a self-directed role.
Strong problem-solving skills and ability to manage complex situations.
Excellent written and verbal communication skills.
Basic computer proficiency.
BSN or MSW required
Minimum of 3 years of relevant experience
Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire
For BSN-prepared candidates: Must hold a current RN license (or compact license) in the state of North Carolina.

Responsibilities

Assess all assigned patients for case management needs, including discharge planning, care transitions, advocacy, consultations, and patient/family education.
Develop, implement, and evaluate individualized discharge plans ensuring timely and appropriate transitions of care.
Coordinate services such as Home Health, Durable Medical Equipment (DME), transportation, Substance Abuse Treatment, outpatient follow-up, Skilled Nursing Facility (SNF) placement, and Acute Rehab referrals.
Monitor daily census to ensure all patients are evaluated for case management needs.
Maintain effective communication with the healthcare team regarding assessment findings, discharge needs, and provider orders.
Provide education to patients, families, and care teams regarding benefits, reimbursement guidelines, and regulatory requirements.
Collaborate with Utilization Management to support payer negotiations, reduce denials, and promote appropriate resource use.
Maintain timely, accurate documentation of assessments, interventions, discharge arrangements, and all actions taken.
Ensure compliance with federal, state, and local regulations, as well as organizational policies.
Prepare reports and maintain records as required.
Participate in Quality Assurance/Performance Improvement (QAPI) activities.
Represent the department with professionalism while fostering positive working relationships across Duke Health and external partners.
Provide weekend, holiday, or after-hours coverage as assigned based on entity needs.