Case Manager-Outpatient Clinic Specialist
1 week ago
We are seeking a skilled Case Manager-Outpatient Clinic professional to join our team at Duke University Health System. As a key member of our healthcare team, you will be responsible for coordinating and completing timely assessments, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care.
Key Responsibilities- Monitor daily census and assignment to ensure 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 healthcare 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.
- BSN or MSW required.
- 3 years of relevant experience.
- Requires Case Management Certification (ACM, CCM, or ANCC) within 3 years of hire.
Duke University Health System is a Magnet organization, consistently recognized as one of the best in the United States. We are committed to providing compassionate care that changes the lives of patients, their loved ones, and the greater community. Our team is dedicated to advancing health together, and we invite you to join us in this mission.
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