Case Manager

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. Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as 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). External candidates eligible for a $7,500.00 Commitment Bonus paid over 1 year.

Responsibilities

• Manage a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care.
• Ensure optimum utilization of the patient's and the Health System's resources and perform these duties within the requirements of CMS and other external review agencies.
• Monitor daily census and assignment to assure all patients are assessed.
• Perform other related duties incidental to the work described herein.
• Case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.
• Maintain effective communication with health care team members related to assessment findings, discharge planning needs and provider orders needed to arrange Homecare, Durable Medical Equipment, Transportation, Skilled Nursing or Acute Rehab Facility placement, Substance Abuse Treatment and outpatient follow-up.
• Maintain working knowledge of specific benefits and reimbursement guidelines, the discharge planning process and applicable federal, state and local regulations.
• Provide education and guidance on these topics to providers, patients and families as needed.
• Work with Utilization Management partners to provide information and feedback that will enhance negotiations and denial prevention with payers.
• Maintain timely documentation of assessment findings, discharge arrangements and actions taken according to departmental guidelines; prepare reports and maintain records as requested and/or required.
• Participate in Quality Assurance/Performance Improvement (QAPI) activities as requested.
• Develop and maintain positive working relationships with customers internal and external to Duke Health System.

Requirements

• BSN or MSW required
• 3 years of relevant experience
• Requires Case Management Certification (ACM, CCM or ANCC) within 3 years of hire.
• If BSN must have current or compact RN licensure in state of NC.

Benefits

• Relocation Assistance (based on eligibility)
• $7,500.00 Commitment Bonus paid over 1 year