Transplant Case Manager
An integral member of the Transplant Interdisciplinary Team. Completes comprehensive psychosocial evaluations for abdominal transplant patients in the inpatient hospital care setting. Assesses patient/family emotional, social, and environmental strengths and barriers and reports to the interdisciplinary team. Advocates and provides support to patients and families as they adapt to the patient’s illness/transplant and changing medical conditions. Serves as a case manager responsible for coordinating continuum of care activities, resources and referrals as well as service delivery and compliance with external review agencies’ requirements. Attendance in weekly listing conferences, rounding and other transplant meetings as determined by the team. May have coverage responsibilities for other Transplant Organ Case Managers. Weekend rotation is required.
Required: Master’s degree in social work from an accredited school of social work; Current licensure as a licensed clinical social worker by the NC Social Work Certification and Licensure Board.
Three or more years of social work experience in a healthcare setting or social service agency with one of three years may be social work internship. Three years of relevant experience required; CCM Preferred; Requires ACM or CCM within two years of hire Previous transplant experience preferred; Social work experience in hospital setting or health care setting preferred. Knowledge of discharge planning and care management.
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.
Coordinate and facilitate timely implementation of discharge plans for assigned patients; arrange follow-up care as appropriate.
Maintain 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 required.
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 assigned.
Provide feedback that will enhance negotiations with payers.
Develop and maintain positive relationships with customers internal and external to Duke Health System.
Perform other related duties incidental to the work described herein.
Knowledge Skills and Abilities
- Ability to work effectively in a self-directed role
- Ability to multi-task, capable of daily problem-solving complex issues
- Excellent written and verbal skills
- Basic computer skills necessary
Duke Entity DUKE HOSPITAL
Job Family Level G1
Full Time / Part Time FULL TIME
Regular / Temporary Regular
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.
BSN or MSW required
3 years of relevant experience
Degrees, Licensures, Certifications
Requires ACM or CCM certification within 3 years of hire. BSN must have current or compact RN licensure in the state of North Carolina. MSW must have a current North Carolina license as a CMSW within 90 days of hire or a current license as an LCSW.