Behavioral Health Case Manager

Duke Careers; Durham (NC); On-site; USD 65,000 - 85,000; Full time

Job summary

Duke Regional Hospital in Durham, North Carolina seeks a licensed clinical social worker to manage designated caseloads, coordinate discharge planning, and oversee care transitions across the continuum of care.

Responsibilities include engaging with the health care team, arranging Homecare and Payer coordination, and ensuring timely documentation while adhering to CMS and local guidelines.

Qualifications

• Master's degree in social work from an accredited school.
• 3 years of relevant adult/mental health experience.
• Active NC LCSW licensure; Notary preferred for consult liaison.
• Duke is an Equal Opportunity Employer and values diversity.

Responsibilities

• Monitor caseload to coordinate discharge planning and care transitions.
• Coordinate with health care team for home care, DME, transportation arrangements.
• Maintain knowledge of benefits, reimbursement guidelines, and regulations.
• Collaborate with Utilization Management to support negotiations with payers.
• Document assessments and discharge plans in accordance with guidelines.
• Perform inpatient discharge planning and post-discharge follow-up.

Skills

LCSW

Adult/Mental health experience

Communication skills

Multi-tasking

Time management

Problem-solving

Basic computer skills

Education

Master's degree in social work

Job description

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At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Regional Hospital

Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight‑loss surgery, women's services, and heart and vascular services.

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.

Work Performed

• Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.
• 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. Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.
• 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.
• Inpatient Job Responsibilities/Activities
• Complete initial assessment within 72 hours to identify psychosocial strengths, weaknesses, community living supports present and needed.
• Contact with patient primary support systems to gather information regarding dynamics and needs of support system.
• Conduct support system/family therapy to allow patient/support to practice skills needed to support community living and/or assist in development of functional patterns of interactions.
• Conduct group sessions for patients focused on skill building/interactional skills.
• Assist patient in development of safety plan to promote positive coping while living in community setting.
• Facilitate discharge planning for patients, involving support systems when possible, to provide level of intervention that creates environment for crisis contacts and safe community living.
• Interface with team to determine multidisciplinary assessment of discharge planning needs and provide information regarding support system/family function.
• Update Interqual.
• Other duties as assigned.
• Typical case load is 10 patients.

Knowledge, Skills and Abilities

• 3 yrs. Adult/Mental health experience preferred
• Ability to work effectively in a self‑directed role
• Ability to multi‑task
• LCSW-A or LCSW
• capable of daily problem‑solving complex issues
• Excellent written and verbal skills
• Basic computer skills necessary

N/A

Minimum Qualifications

Education

Master's degree in social work from an accredited school of social work.

Experience

3 years of relevant experience.

Degrees, Licensures, Certifications

Current licensure as a licensed clinical social worker (LCSW) by the NC Social Work Certification and Licensure Board. Consult/Liason should also be a Notary.

Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military 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.

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.

Nearest Major Market: Durham Nearest Secondary Market: Raleigh

Read more about Duke’s commitment to affirmative action and nondiscrimination at hr.duke.edu/eeo.