Manager, Case Management

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About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Health hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

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 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 activities.
• 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.
• Ensures compliance with licensure and certification requirements of new and existing employees.
• 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…