Case Manager-Duke Raleigh ED Job at Duke Health

Duke Health Raleigh, NC 27611

Duke Raleigh Hospital Duke Raleigh Hospital offers the latest in care and technology in a patient-friendly setting. It has been an important part of Duke Health since 1998 and has served Wake County for more than 35 years, employing more than 2,000 teammembers. The hospital provides 186 inpatient beds and a comprehensive array of services, including the Duke Raleigh Cancer Center, Duke Raleigh Orthopedic and Spine Center, cardiovascular services, neurosciences including the Duke Raleigh Skull Base and Cerebrovascular Center, advanced digestive care, disease management and prevention, wound healing, outpatient imaging, intensive and progressive care, pain clinic, same-day surgery, emergency department and community outreach and education programs. U.S.News & World Report ranked Duke Raleigh Hospital as high performing in orthopaedics and five adult procedures/conditions: chronic obstructive pulmonary disease (COPD), heart failure, kidney failure, lung cancer surgery, and stroke.

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)


Occ Summary

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.


Work Performed

  • Monitor daily census and assignment to assure 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 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.


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


Level Characteristics

N/A


Minimum Qualifications

Education

BSN or MSW required


Experience

3 years of relevant experience


Degrees, Licensures, Certifications

Requires Case Management Certification (ACM, CCM or ANCC) within 2 years or of hire. BSN required and must have current or compact RN licensure in state of NC. MSW

Job Code: 00005013 CASE MANAGER
Job Level: G2


Duke is an Affirmative Action/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, 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 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.




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