CASE MANAGER -PEDIATRICS

  • Requisition Number: 1279
  • Department: DUKE HOSPITAL
  • Location: Durham
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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 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!

 

Occ Summary

Responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery and compliance with external review agencies' requirements.


Work Performed

Coordinate and facilitate timely implementation of discharge plans for required. assigned. Perform Maintain other related duties incidental to the work described herein. assigned patients; arrange follow-up care as appropriate. effective communication with health care team members related to discharge planning and utilization management. Document findings, discharge arrangements and actions taken according to departmental guidelines; prepare reports and maintain records as Act as an educational resource and provide consultation to hospital medical personnel regarding discharge planning process and applicable federal, state and local regulations; identify benefits, implications and limitations of home care as appropriate. Provide concurrent review and follow up with appropriate personnel regarding denials. Collect denial data for trending Work with appropriate staff to develop processes to prevent denials and improve reimbursement. Collect analyze and report data for resource utilization, compliance, QI and other areas as Provide feedback that will enhance negotiations with payers. Develop and maintain positive relationships with customers internal and external to Duke Health System.


Knowledge, Skills and Abilities

Ability to work effectively in a self-directed role necessary issues Ability to multi-task, capable of daily problem-solving complex Excellent written and verbal skills Basic computer skills


Level Characteristics

N/A

 

Duke University 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.