COMPLEX CASE MANAGER- DUKE RALEIGHJob ID 137620 Date Posted 04/10/2022
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 team members. 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 two adult procedures/conditions: Chronic Obstructive Pulmonary Disease (COPD) and lung cancer surgery. #DukeRaleighJobs
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!
Responsible for Complex Care patients in a variety of areas at Duke Regional. Also, 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.
- 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
BSN or MSW required
3 years of relevant experience; Hospital Case Management preferred
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: G1
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.
"Nourishing our community and building a healthy community is part of our vision as an organization and that is absolutely supported in our day-to-day."Lisa, Assistant Director of Nutritional Services
"Duke Raleigh Hospital is a really tight-knit work family. We check on each other when we’re not here, we do things outside of work. It’s an extension of my family."Ashley, Respiratory Therapist
"I enjoy the generous PTO package."Lillian, Environmental Services