Case Manager

UNC Health Care; Kinston (NC); On-site; USD 54,000 - 82,000; Full time

Job summary

UNC Health Care in North Carolina is seeking a Case Manager within Care Management to lead discharge planning, patient teaching and care coordination for successful community or facility transitions. Experience with inpatient rehabilitation and compliance with insurance guidelines is required.

You will advocate for patients, collaborate with the health team, and support quality, cost-effective care across payors and settings.

Qualifications

• Graduate from an accredited school of nursing or Medical Social Worker.
• Baccalaureate Degree in Human Services area accepted.
• Case Manager Certification within 5 years encouraged.
• Two–Three years experience in hospital, nursing home, or community agency.
• Certification by ABQA/UR or InterQual; license in NC for RN.
• Knowledge of InterQual ISD-A criteria; strong interpersonal & communication skills.

Responsibilities

• Coordinates discharge planning, patient teaching and related activities for successful discharge to home, community or facility.
• In inpatient rehab, coordinates care, secures access to resources and supports recovery.
• Advocates for patient needs and promotes quality, cost‑effective care.

Skills

InterQual ISD-A criteria

Discharge planning

Patient education

Communication

Autonomy in work

Education

RN license

SW certification

Baccalaureate in Human Services

Tools

InterQual

Job description

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

• The Case Manager Coordinates discharge planning, patient teaching and other associated activities for successful discharge community/home re-entry or to nursing facilities. In inpatient rehabilitation, medical case management involvescoordinating a patient's care, ensuring access to resources, and supporting their recovery journey. Completes, monitors and assures compliance with Federal, State and Third-Party Insurance guidelines. This includes working with the healthcare team to develop and implement a rehabilitation plan, monitoring the patient's progress, and assisting with discharge planning.Case managers also advocate for the patient's needs and ensure quality, cost-effective care

Responsibilities:

• Patients/Families, physicians, community agencies, business associates & staff. Conducts interpersonal relationships designed to project positive image of department and hospital. Always helpful, courteous and friendly.

Other information:

• EDUCATION
  • Graduate from an accredited school of nursing or Medical Social Worker. Baccalaureate Degree in Human Services area accepted. Obtain Case Manager Certification within 5 years encouraged.
• EXPERIENCE
  • Two-Three years experience in hospital, nursing home, or community agency.
• LICENSURE/REGISTRATION/CERTIFICATION
  • Certification by American Board of QA/UR or InterQual, Certification in Social Work, Licensed in N.C. for RN
• OTHER SKILLS AND QUALIFICATIONS
  • Possess knowledge skills of InterQual ISD-A criteria. Good interpersonal and communication skills. Demonstrates understanding of patient care needs according to developmental stages for various age groups. Knowledge of State and Federal Regulations regarding admission/reimbursement of Medicare/Medicaid/all other payor sources. Reading and mathematics. Must be able to work autonomously.
• WORK ENVIRONMENT
  • Exposure to Airborne and Bloodborne Pathogens, Exposure to electrical hazards (equipment use)
• PHYSICAL REQUIREMENTS
  • Standing, Walking, Sitting, Reaching, Talking, Seeing, Hearing, Tasting, Smelling, Carrying, Pushing, Pulling, Lifting, and Moving.

Job Details

Legal Employer: Lenoir Health

Entity: UNC Lenoir Health Care

Organization Unit: Care Management

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: LENOIR MEM

Exempt From Overtime: Exempt: No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.