Case Manager-Outpatient Clinic Specialist

4 weeks ago


Durham, North Carolina, United States Duke University Health System Full time

About the Role

Duke University Health System is seeking a skilled Case Manager-Outpatient Clinic professional to join our team. 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.

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 University Health System

Duke University Health System is a Magnet organization, consistently recognized as North Carolina's Great 100 Nurses. 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.

Essential Physical Job Functions

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.



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