Case Manager - As Needed - Quality - Nags Head, NC

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The Outer Banks Hospital



Vidant Health

About the Outer Banks Hospital

Located in the beautiful coastal town of Nags Head, NC. The Outer Banks Hospital offers high-quality care in a compassionate environment—it’s what we’re known for on the Outer Banks.

We opened in March 2002 as a joint venture between Vidant Health and Chesapeake Regional Healthcare. Our facility includes eighteen acute care medical-surgical beds, two labor and delivery/recovery/post-partum beds, a level II nursery bed, a designated caesarian section room, three operating rooms, outpatient and diagnostic services along with a 24-hour emergency department. Affiliated with The Outer Banks Hospital is The Outer Banks Medical Group (a Vidant Medical Group partner) which is comprised of eight physician practices.

As a community hospital, we offer a broad range of inpatient and outpatient services. We meet the health care needs of our coastal community, whose year-round population of 35,000 swells to 250,000 in the summer months.

We welcome you to make a difference with us and become a part of a collaborative community that touches lives, including yours.


Position Summary

Reports directly to the Director of Quality/Case Management and is responsible using a collaborative process to plan, implement, monitor and evaluate the options and services requested to meet and individual’s health needs.  This is done by communicating and utilizing available resources to promote quality, medical appropriateness and cost-effective outcomes in the best interest of the patient.  The Case Manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being utilized in a manner that is cost-effective and timely in order to obtain value for both the client and reimbursement source.


  • Ensures all patients (inpatients, observation, Medical/Surgical Unit and LDRP) meet the criteria for Medical Necessity.

  • Serves as a resource for TOBH staff, patients and their families for Ethical and End of Life decision making.

  • Provides a link for referrals to community resources/agencies to ensure patient’s needs are met/available at discharges without a lapse in services. (i.e. Home Health, medical equipment)

  • Maintains knowledge and competence in financial/reimbursement requirements as related to LTC (FL-2), EDS and CMS. (Medicare and Medicaid)

  • Incorporates knowledge of federal, state and accreditory bodies as related to regulations and requirements (i.e. CAH LOS, referrals, observation vs. admission) of standard components necessary to maintain such compliance.

  • Collaborates effectively with all members of the Leadership/Administrative teams, hospital staff and Medical Staff.

  • Initiates processes for patients that meet eligibility requirements for financial assistance and refers to appropriate resources.

  • Collaborates with the Business Office with review and revision of denials, as well as insurance status of self-pay population.

  • Responds to requests for consults in a timely manner to ensure patient/family needs are met in the timeliest manner possible.

  • Assists with and contributes to education programs and orientation for new Team Members in regards to Case Management services, End of Life decision making and identification of abuse victims (legally mandated).  Serves as a resource for TOBH staff, patients and their families for Ethical and End of Life decision making.

  • Other duties as assigned.

Minimum Requirements


Bachelor degree in Social Work or related field with clinical case management experience or RN with clinical case management experience.  Preference for MSW or BSN with clinical case management experience.



Must have 3 – 5 years of various clinical experience and a minimum of 2 – 3 years of Case Management experience.

Other Information

This is a PRN, as needed, position.  There are NO guaranteed hours.  

This position is not eligible for team member benefits.

This position reports to Quality.

General Statement

It is the goal of Vidant Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer.   Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.

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