Outpatient Clinic Case Coordinator

1 week ago

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

Internal Number: 244383

At Duke Health, we are dedicated to providing compassionate care that transforms the lives of patients, their families, and the broader community. Explore how we can work together to enhance health outcomes.

About Duke University Hospital

Pursue your passion for patient care with Duke University Hospital, a leader in healthcare excellence located in Durham, North Carolina. Recognized as one of the top hospitals in the United States, it is the largest facility within Duke Health, featuring 1,048 patient beds and 65 operating rooms, along with comprehensive diagnostic and therapeutic services, including a regional emergency/trauma center and an endo-surgery center.

Duke Nursing Highlights:

  • Designated as a Magnet organization for nursing excellence.
  • Nurses are consistently honored as part of North Carolina's Great 100 Nurses.
  • Awarded for advocacy in nursing certification by the American Board of Nursing Specialties.
  • Registered nurses are a vital part of our healthcare team.
  • Quality of Life: Enjoy living in the Triangle area.
  • Relocation assistance may be available based on eligibility.

External candidates may qualify for a $10,000 Commitment Bonus distributed over two years.

Job Summary

Oversee a designated caseload to facilitate and complete timely assessments, planning, implementation, and evaluation of discharge plans and care transitions throughout the care continuum. Ensure optimal utilization of both patient and Health System resources while adhering to the requirements set forth by CMS and other external review organizations.

Responsibilities

  • Monitor daily patient census and assignments to ensure all patients receive assessments.
  • Perform additional duties as required.
  • Address case management needs, including care coordination, transition planning, and discharge planning. Maintain effective communication with healthcare team members regarding assessment findings, discharge planning needs, and necessary provider orders for arranging home care, durable medical equipment, transportation, skilled nursing, or rehabilitation services.
  • Stay informed about specific benefits and reimbursement guidelines, the discharge planning process, and relevant federal, state, and local regulations.
  • Provide education and guidance on these topics to providers, patients, and families as necessary.
  • Collaborate with Utilization Management partners to enhance negotiations and prevent denials with payers.
  • Ensure timely documentation of assessment findings, discharge arrangements, and actions taken in accordance with departmental guidelines; prepare reports and maintain records as required.
  • Participate in Quality Assurance/Performance Improvement (QAPI) initiatives as requested.
  • Responsibilities may include site-specific duties, weekend/holiday, or after-hours coverage as designated.
  • Foster and maintain positive working relationships with both internal and external customers of Duke Health System.

Knowledge, Skills, and Abilities

Ability to work effectively in a self-directed capacity, manage multiple tasks, and solve complex issues daily. Excellent written and verbal communication skills are essential, along with basic computer proficiency.

Minimum Qualifications

Education

A BSN or MSW is required.

Experience

A minimum of three years of relevant experience is necessary.

Certifications

Case Management Certification (ACM, CCM, or ANCC) is required within three years of hire. A current or compact RN licensure in the state of NC is mandatory for BSN candidates.

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunities without regard to age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that flourishes when diverse perspectives, backgrounds, and experiences are valued. To achieve this, it is essential that all community members feel secure and welcome, that individual contributions are respected, and that all voices are heard. Every member of our community has a responsibility to uphold these values.

Essential Physical Job Functions: Certain positions at Duke University and Duke University Health System may involve essential job functions requiring specific physical and/or mental abilities. Additional information and provisions for requests for reasonable accommodation will be provided by each hiring department.

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