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Case Manager

2 months ago


Durham, North Carolina, United States Duke Health Full time
About the Role

We are seeking a skilled Case Manager to join our team at Duke Health. As a Case Manager, you will play a critical role in 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.
Requirements
  • BSN or MSW required.
  • 3 years of relevant experience.
  • Requires Case Management Certification (ACM, CCM, or ANCC) within 3 years of hire.
About Duke Health

Duke Health is a Magnet organization and a leader in healthcare innovation. We are committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

We strive to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes.