Manager, Case Management-Duke Regional
Company: Duke Health
Posted on: January 27, 2023
Duke Regional Hospital Duke Regional Hospital offers the
personal touch and hometown feel of a community hospital while
serving as an essential arm of internationally recognized Duke
University Health System. Duke Regional has served Durham, Orange,
Person, Granville and Alamance counties for more than 45 years. To
be successful at caring for our community and have a strong
reputation among patients who seek our care, we have 3,500 team
members who work together to provide exceptional, compassionate and
equitable healthcare 24/7. We are a place of learning and
acceptance for team members just starting their careers, as well as
an institution of family culture and professional development for
employees who have served for decades in our hospital units.Duke
Regional has 388 inpatient beds and offers a comprehensive range of
medical, surgical and diagnostic services, including orthopedics,
weight-loss surgery, women's services, and heart and vascular
services. We also offer care at our Duke Rehabilitation Institute,
Davis Ambulatory Surgical Center, Duke Ambulatory Surgery Center
Arringdon, Health Services Center, and Duke Behavioral Health
Center North Durham. In fiscal year 2021, Duke Regional Hospital
admitted 16,422 patients, performed 18,152 surgeries and welcomed
2,673 babies into the world. U.S. News & World Report ranked Duke
Regional Hospital as in North Carolina and in the Raleigh-Durham
area for 2021-22. The Human Rights Campaign consistently names us a
Healthcare Equality Leader, and we are a Joint
Commission-accredited and Magnet-designated hospital.
The Manager reports directly to the Assistant Director of the Case
Management Department and provides direct supervision and oversight
of the Case Managers (CMs) and Clinical Social Workers (CSWs ) who
function within the inpatient and outpatient settings. The Manager
is responsible for operationalizing Case Management and Clinical
Social Work workflow standards and processes, ensuring adherence to
regulatory guidelines and ensuring operations are consistent with
DUHS organizational standards.
- Functions as a departmental subject matter expert.
- In conjunction with the Team Leaders, the Manager will assess
the daily census assignment ensuring acuity and caseloads are
- Provides hands-on support for critical staffing needs.
- Monitors productivity.
- Partners with CM Director, Assistant Directors and Managers in
conducting leadership rounds to support workflow and staff
- Development and oversight of UM work schedules/calendar
management via API in accordance with the PTO policy.
- Ensure adherence to all Case Management Department and DUHS
- Ensures adherence to regulatory compliance.
- Promotes an environment of interdepartmental, health system and
post- acute care collaboration.
- Attends and contributes to the Utilization Management Committee
- Will participate in the development and presentation of
projects and education topics to designated departments, provider
groups, clinical service units and community collaborators as
- Collaboration with CSU leadership on continuous process
- In collaboration with the Directors and Human Resources,
manages the recruitment, hiring, onboarding and retention of Case
Management Department staff.
- Will conduct employee 30/60/90 day evaluations as well as
mid-year and end of year evaluations.
- In conjunction with the Director, maintains employee Human
Resource and secondary files in accordance to Joint Commission and
- Ensures compliance with licensure and certification
requirements of new and existing employees.
- In conjunction with TLs, will support daily patient flow
- Provides education to support regulatory compliance in
collaboration with DUHS Compliance and CM Department
- Conducts Utilization Management Divisional Meetings.
- Provide education and feedback to provider groups as
- Monitors monthly reporting including but not limited to UM
productivity, Readmission Documentation, Initial Time to Review,
Avoidable Days Documentation, Denials Management and Discharge
Appeals processes. Collaborates with the Directors and Team Leads
- Works with the Physician Advisors and Medical Directors on
escalation of care and process improvement activities including but
not limited to LOSM, readmissions, avoidable days, denial
management, problem solving and education needs.
- Participates in the review and updating of Case Management
policies. - Escalates and keeps Directors informed of workflow or
personnel concerns. Knowledge, Skills and Abilities
Experience withcare coordination, discharge planning, clinical
information documentation and Utilization review.
PC proficiency and experience with care management workflow
systems, such as Canopy Knowledge of InterQual criteria and patient
status change Strong communication and leadership skills
Knowledgeable of JCAHO, federal and state
Considerable knowledge of large-scale health care facilities,
policies, and issues.
Considerable knowledge of clinical protocols and practice
management requirements in assigned area.
Ability to analyze data and employ approved management techniques
and statistical tools to obtain maximum effectiveness,
Ability to interpret established policies into operating procedures
and to execute case management programs.
Ability to coordinate effectively various functions and activities
for maximum cooperation and efficiency
Ability to direct, instruct and advise staff in the approved
methods, procedures and practices employed in effective health care
Ability to receive and effectively react to day-to-day problems
presented by staff as well as others Knowledge of accreditation
standards, health care regulations, performance improvement,
patient safety and policy formulation.
Effective organizational, oral and written communication skills,
problem solving, program development, computer skills, strong
leadership, and team building skills.
Ability to work with a variety of disciplines and levels of staff
across departments and the health system is required.
Knowledge of payer requirements and discharge planning regulations
that support the effect development of departmental policies,
procedures and standards Ability to establish priorities, meet
deadlines, develop and manage the department's productivity
standard in the management of the work assignment
Ability to form positive, collaborative relationships with members
of the executive team, hospital staff, post-acute providers and
Ability to effectively negotiate with internal and external service
providers Knowledge of information systems to support the
evaluation of current capacity as well as future needs
BSN or MSW required
5 years of relevant experience
Degrees,Licensure, and/or Certification
Must have current or compact RN licensure in the state of North
Carolina or current licensure as a licensed clinical social worker
by the NC Social Work Certification and Licensure Board
Job Code: MANAGER, CASE MANAGEMENT
Job Level: I1
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 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.
Keywords: Duke Health, Durham , Manager, Case Management-Duke Regional, Executive , Durham, North Carolina
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