Case Manager-Outpatient Clinic Specialist

6 days ago

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

Duke University Health System is a leading academic medical center that provides comprehensive care to patients across the United States. Our team of healthcare professionals is dedicated to delivering exceptional patient care and advancing the field of medicine through innovative research and education.

Job Summary

We are seeking a highly skilled Case Manager-Outpatient Clinic Specialist to join our team. The successful candidate 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.
  • Job responsibilities may include site-specific duties, weekend/holiday or after-hours coverage as designated at each entity.
  • 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.
Duke University Health System is an Equal Opportunity Employer

Duke University Health System is 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.

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