Case Manager – DUH PEDS

Duke University Hospital is consistently rated as one of the best in the United States and is known around the world for its outstanding care and groundbreaking research.

Duke University Hospital has 957 inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 51 operating rooms; an endo-surgery center; an Ambulatory Surgery Center with nine operating rooms and an extensive diagnostic and interventional radiology area.

In fiscal year 2018, Duke University Hospital admitted 42,916 patients and had 1,085,740 outpatient visits in fiscal year 2017.

U.S News & World Report named Duke University Hospital #1 in North Carolina and #1 in the Raleigh-Durham area in 2018-19.

Duke University Hospital is ranked in the top 20 nationally for seven adult specialties, including cardiology and heart surgery, nephrology, ophthalmology, orthopedics, pulmonology, rheumatology, and urology.

In addition to its hospitals, Duke Health has an extensive, geographically dispersed network of outpatient facilities that include primary care offices, urgent care centers, multi-specialty clinics and outpatient surgery centers.

Duke Nursing Highlights:

Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognizedeach year as North Carolinas 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!

Occ Summary Work PerformedN/AKnowled ge, Skills and AbilitiesLevel Characteristicsrequired.requirements.assig ned.PerformnecessaryMaintainissuesAbility toResponsible for coordinating continuum of care activities for assignedpatients and ensuringoptimum u tilization of resources, service delivery and compliance withexternal re view agencies’Coordinate and facilitate timely implementation of dischar ge plans forother related dutiesincidental to the work described herein.

assigned patients; arrange follow-up care as appropriate.effective commu nication with health care team members related todischarge planning andu tilization management.Documentfindings, discharge arrangements and actio ns taken according todepartmental guidelines; preparereports and maintai n records asAct as an educational resource and provideconsultation to ho spital medical personnel regarding discharge planningprocess and applica blefederal, state and local regulations; identify benefits, implications and limitations of home care asappropriate.

Provide concurrent review an d follow up with appropriatepersonnel regarding denials.Collect denial d ata fortrendingWork with appropriate staff to develop processes topreven t denials and improve reimbursement.Collect analyze andreport data for r esource utilization, compliance, QI and other areas asProvide feedback t hat willenhance negotiations withpayers.Develop and maintain positive re lationships withcustomers internal and external to Duke Health System.Ab ility to work effectively in a self-directed rolemulti-task, capable of daily problem-solving complexExcellent written and verbal skillsBasic co mputer skills
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

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 ideasan 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 essentialjob 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.

Nearest Major Market: Durham
Nearest Secondary Market: Raleigh