RN Care Manager/Community Educator serving clients and caregivers, blending nursing expertise and community outreach in Williamsburg. Building relationships and supporting quality care delivery.
About the role
- Case Manager coordinating and evaluating discharge plans and care transitions at Duke University Hospital. Ensuring optimum resource utilization and communication with healthcare teams.
Responsibilities
- 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.
- 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.
- Develop and maintain positive working relationships with customers internal and external to Duke Health System.
Requirements
- BSN or MSW required
- 3 years of relevant experience
- Requires Case Management Certification (ACM, CCM or ANCC) within 3 years of hire
- If BSN must have current or compact RN licensure in state of NC
Benefits
- Relocation Assistance (based on eligibility)
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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