Case Manager Oncology

About the role

The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care. This role supports optimal patient outcomes, effective resource utilization, and compliance with CMS and other regulatory agencies. The Case Manager collaborates closely with interdisciplinary teams, patients, families, and community partners to coordinate safe, efficient care transitions.

Responsibilities

• Care Coordination & Discharge Planning
• Assess all assigned patients for case management needs, including discharge planning, care transitions, advocacy, consultations, and patient/family education.
• Develop, implement, and evaluate individualized discharge plans ensuring timely and appropriate transitions of care.
• Cook up services such as Home Health, Durable Medical Equipment (DME), transportation, Substance Abuse Treatment, outpatient follow-up, Skilled Nursing Facility (SNF) placement, and Acute Rehab referrals.
• Maintain daily census to ensure all patients are evaluated for case management needs.
• Collaboration & Communication
• Maintain effective communication with the healthcare team regarding assessment findings, discharge needs, and provider orders.
• Provide education to patients, families, and care teams regarding benefits, reimbursement guidelines, and regulatory requirements.
• Collaborate with Utilization Management to support payer negotiations, reduce denials, and promote appropriate resource use.
• Documentation & Compliance
• Maintain timely, accurate documentation of assessments, interventions, discharge arrangements, and all actions taken.
• Ensure compliance with federal, state, and local regulations, as well as organizational policies.
• Prepare reports and maintain records as required.
• Quality & Professional Development
• Participate in Quality Assurance/Performance Improvement (QAPI) activities.
• Represent the department with professionalism while fostering positive working relationships across Duke Health and external partners.
• Provide weekend, holiday, or after-hours coverage as assigned based on entity needs.

Qualifications

• Education: BSN or MSW required.
• Experience: Minimum of 3 years of relevant experience.
• Licenses and Certifications: Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire. For BSN-prepared candidates: Must hold a current RN license (or compact license) in the state of North Carolina.