Full-Time

Case Manager PRN

Duke University

Duke University

No salary listed

Durham, NC, USA

In Person

On-site at Duke University Hospital in Durham, NC.

Category
Medical, Clinical & Veterinary (1)
Requirements
  • BSN or MSW required
  • 3 years of relevant experience
  • 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)
Responsibilities
  • 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.

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