Case Manager - Care Management
Stony Brook, NY 
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Posted 1 month ago
Job Description




Position Summary


At Stony Brook Medicine, a TH Staff Associate/Case Manager is a valuable member of our team, who provides clinical services to our patient population.

 

Qualified candidates will demonstrate superior patient care and possess outstanding communication skills while adhering to our high standard of excellence.


 

Duties of a TH Staff Associate/Case Manager in the Care Management Department may include the following but are not limited to:

  • Screen patients for Level of Care i.e. Inpatient, Observation, Emergency and other outpatient services.
  • Coordination of Care with Interdisciplinary team.
  • Resource Management- including capturing Avoidable Days, over utilization of services, etc.
  • Discharge Planning Activities which includes communication with the interdisciplinary team, patient and/or significant other, early coordination with post-acute providers.
  • Develop and document Assessment, Patient Progress Note and Transitional Care Plan.
  • Retrospective reviews when needed for short stay admissions.
  • Active participation with insurance and physician to avoid denials and/or work to reverse negative denial decisions from payer.
  • Review all admissions for appropriate level of care.
  • Communicate with physicians, transferring hospitals, payers, admitting for authorization prior to transfer.
  • Prepare PRI, departmental forms, ensure education of patient and family with accurate documentation throughout hospital stay and at discharge.
  • Active participation in performance improvement, department activities and data collection efforts.
  • Always maintain a high level of customer service.

Qualifications


Required RN Licensure in NY State. At least five years of Acute Care Nursing Experience. Bachelor Degree or Associate Degree working on a Bachelor Degree. Knowledge of Length of Stay and discharge planning. Computer proficient in Electronic Medical Record applications. Leadership skills, ability to run meetings, rounds, etc. High level of customer service skills. Weekday and Weekend flexibility.

 

Preferred:  Master degree. Experience in CM, UR, Coding, Risk or Quality.  Experience in NICU, Pediatrics or Emergency Room. Experience in Managed Care/Insurance Industry/MD Office.  Certified in Case Management, UR, or Quality.  Working knowledge of MCG/Interqual criteria.  PRI Certified. Recent experience in tertiary care hospital.  Knowledge of regulatory requirements i.e. CMS, EMTALA, Managed Care, etc.  Bi-lingual.  Leadership skills.

  

Special Notes:   Resume/CV and cover letter should be included with the online application.

Posting Overview:  This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date).

If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.

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  • Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
  • All Hospital positions maybe subject to changes in pass days and shifts as necessary. 
  • This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair. 
  • This function/position maybe designated as essential. This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.
 
Prior to start date, the selected candidate must meet the following requirements:

  • Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services*
  • Complete electronic reference check with a minimum of three (3) professional references.
  • Successfully complete a 5 panel drug screen*
  • Successfully complete a Background Check investigation.
  • Provide a copy of any required New York State license(s)/certificate(s).

Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.
 
*The hiring department will be responsible for any fee incurred for examination.
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Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
 
If you need a disability-related accommodation, please call the University Office of Equity and Access at (631)632-6280.
 
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Official Job Title: TH Staff Associate
Job Field: Other
Primary Location: US-NY-Stony Brook
Department/Hiring Area: Care Management-Stony Brook University Hospital
Schedule: Full-time Shift: Day Shift Shift Hours: 8:30 AM - 5:00 PM Pass Days: Sat, Sun
Posting Start Date: Oct 29, 2020
Posting End Date: Jan 28, 2021, 4:59:00 AM
Salary: Commensurate with experience
Salary Grade: SL4

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Associate Degree
Required Experience
5+ years
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