Case Manager at Duke Health

Mooresville, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

18 Apr, 26

Salary

0.0

Posted On

18 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Case Management, Care Coordination, Discharge Planning, Communication, Education, Documentation, Quality Assurance, Problem-Solving, Multi-Tasking, Advocacy, Utilization Management, Regulatory Knowledge, Team Collaboration, Patient Advocacy, Healthcare Regulations, Resource Utilization

Industry

Hospitals and Health Care

Description

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Duke Health Lake Norman Hospital Pursue your passion for caring with Duke Health Lake Norman Hospital in Mooresville, North Carolina. The smallest of Duke Healthâ€™s four hospitals at 123-beds, it offers a comprehensive range of medical services, including 24-hour emergency care, cardiology, orthopedics, women's services, and surgical specialties. Duke Nursing Highlights: Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility) General Description of the Job Class Manage a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System's resources and perform these duties within the requirements of CMS and other external review agencies. Duties and Responsibilities of this Level Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education. Maintain effective communication with health care 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. Perform other related duties incidental to the work described herein. Required Qualifications at this Level Education BSN or MSW required Experience 3 years of relevant experience Degrees, Licensure, and/or Certification Requires Case Management Certification (ACM, CCM or ANCC) within 3 years of hire. BSN required and must have current or compact RN licensure in state of NC. or MSW(if no BSN or compact RN licensure in NC) Knowledge, Skills, and Abilities Ability to work effectively in a self-directed role Ability to multi-task, capable of daily problem-solving complex issues Excellent written and verbal skills Basic computer skills necessary Distinguishing Characteristics of this Level N/A Duke is an Equal Opportunity Employer 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 (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. 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.

Responsibilities

Manage a designated caseload to coordinate and complete timely assessment, planning, implementation, and evaluation of discharge plans and care transitions. Ensure optimum utilization of the patient's and the Health System's resources while adhering to CMS and other external review agency requirements.