Behavioral Health Case Manager, Manager-NC LCSW Highly Preferred - Durham, United States - Duke University

Description

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, which ranks as the number four hospital in the Raleigh-Durham, North Carolina area, accordingto U.S. News and World Report for Duke Regional Hospital is the second largest of Duke Health's three hospitals and offers a comprehensive range of medical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services.

Occ Summary

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.

Work Performed

• Functions as a departmental subject matter expert. activities.
• In conjunction with the Team Leaders, the Manager will assess the daily census assignment ensuring acuity and caseloads are equitable.
• Provides hands-on support for critical staffing needs.
• Monitors productivity.
• Partnering with Assistant Director's and Director in conducting leadership rounds to support workflow and staff engagement.
• Development and oversight of CM and CSW work schedules/calendar management via API in accordance with the PTO policy.
• Ensure adherence to all Case Management Department and DUHS organizational policies.
• 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 meeting.
• Will participate in the development and presentation of projects and education topics to designated departments, provider groups, clinical service units and post-acute care arenas as indicated.
• Collaboration with CSU leadership on continuous process improvement
• In collaboration with the Assistant 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 Administrative Director, maintains employee Human Resource and secondary files in accordance to Joint Commission and DUHS guidelines. new and existing employees.
• Ensures compliance with licensure and certification requirements of
• In conjunction with TLs, will support daily patient flow huddles.
• Provides education to support regulatory compliance in collaboration with DUHS Compliance and CM Department leadership.
• Conducts Case Management team meetings.
• Participates in monthly CM/CSW Divisional Meetings.
• Provide education and feedback to provider groups as indicated
• Monitors monthly reporting including but not limited to CM productivity, Readmission Documentation, Initial Time to Assessment, Avoidable Days Documentation, Important Message from Medicare Compliance and Discharge Appeals processes. Collaborates with the Assistant Director regarding outcomes.
• 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 Assistant Director/Director 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 standards/regulations 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, efficiency, and 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, administration 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 payers 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

Level Characteristics

N/A

Work Hours

Mon- Fri 8am- 5 pm, some nights, weekends, holidays, and On-call required.

Minimum Qualifications

Education

BSN or MSW required

Experience

5 years of relevant experience and 3 years of supervisory experience

Degrees, Licensures, Certifications

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.

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.

Nearest Major Market: Durham

Nearest Secondary Market: Raleigh