Duke Careers
Location
Durham, North Carolina
The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, and implementation of discharge plans and care transitions. They collaborate with interdisciplinary teams to support optimal patient outcomes and ensure compliance with regulatory agencies.
Candidates must hold a BSN or MSW degree and have a minimum of 3 years of relevant experience. A Case Management Certification (ACM, CCM, or ANCC) is required within 3 years of hire, and BSN candidates must hold a current North Carolina RN license.
Assess all assigned patients for case management needs, including discharge planning, care transitions, advocacy, consultations, and patient/family education. Develop, implement, and evaluate individualized discharge plans ensuring timely and appropriate transitions of care. Coordinate services such as Home Health, Durable Medical Equipment (DME), transportation, Substance Abuse Treatment, outpatient follow-up, Skilled Nursing Facility (SNF) placement, and Acute Rehab referrals. Monitor daily census to ensure all patients are evaluated for case management needs.
Collaboration & Communication
Maintain effective communication with the healthcare team regarding assessment findings, discharge needs, and provider orders. Provide education to patients, families, and care teams regarding benefits, reimbursement guidelines, and regulatory requirements. Collaborate with Utilization Management to support payer negotiations, reduce denials, and promote appropriate resource use.
Documentation & Compliance
Maintain timely, accurate documentation of assessments, interventions, discharge arrangements, and all actions taken. Ensure compliance with federal, state, and local regulations, as well as organizational policies. Prepare reports and maintain records as required.
Quality & Professional Development
Participate in Quality Assurance/Performance Improvement (QAPI) activities. Represent the department with professionalism while fostering positive working relationships across Duke Health and external partners. Provide weekend, holiday, or after-hours coverage as assigned based on entity needs.
Knowledge, Skills & Abilities
Ability to work independently in a self-directed role. Strong problem-solving skills and ability to manage complex situations. Excellent written and verbal communication skills. Basic computer proficiency.
Minimum Qualifications: Education
BSN or MSW required
Experience: Minimum of 3 years of relevant experience
License and Certification
Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire For BSN-prepared candidates: Must hold a current RN license (or compact license) in the state of North Carolina.
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