Population Health Care Manager – Complex Care Management
Duke Careers
full-time
Posted on:
Location Type: Office
Location: Durham • North Carolina • United States
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About the role
- Responsible for Complex Care patients in a variety of areas at Duke University Hospital.
- 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.
- Monitor daily census and assignment to assure all patients are assessed.
- 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.
Requirements
- BSN or MSW required
- 3 years of relevant experience; Hospital Case Management preferred
- 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.
Benefits
- Health insurance
- Flexible work arrangements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
discharge planningcare transitionsassessmentdocumentationutilization managementreimbursement guidelinescase management
Soft skills
effective communicationeducationguidance
Certifications
Case Management CertificationACMCCMANCC