Stony Brook University Case Manager - Care Management in Stony Brook, New York
Case Manager - Care Management
At Stony Brook Medicine, a 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 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
Selected candidate will be required to provide periodicweekend coverage.
Required Qualifications : RNLicensure in NY State. At least five years of Acute Care Nursing Experience.Bachelor Degree or Associate Degree working on a Bachelor Degree. Knowledge ofLength of Stay and discharge planning. Computer proficient in ElectronicMedical Record applications. Leadership skills, ability to run meetings,rounds, etc. High level of customer service skills. Weekday and Weekendflexibility.
PreferredQualifications: Masterdegree. Experience in CM, UR, Coding, Risk or Quality. Experience in NICU, Pediatrics or Emergency Room. Experience in ManagedCare/Insurance Industry/MD Office. Certified in Case Management, UR, orQuality. Working knowledge of MCG/Interqual criteria. PRICertified. Recent experience in tertiary care hospital. Knowledge ofregulatory requirements i.e. CMS, EMTALA, Managed Care, etc. Bi-lingual. Leadership skills.
* Special Notes: * 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 are subject to changes in pass daysand shifts as necessary. This position may require the wearing ofrespiratory protection, which may prohibit the wearing of facial hair.
The selected candidate must successfully clear a background investigation. 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 (The hiring department will be responsible for any fee incurred for examination), submit (3) written references, and provide a copy of any required New York State license(s)/certificate(s). Please be advised that failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.
The best ideas in medicine start with the best people. At Stony Brook Medicine, our highest calling is to put the power of ideas to work in our patients’ lives. Stony Brook Medicine integrates and elevates all of our health-related initiatives: education, research and patient care. Stony Brook Medicine is Long Island’s premier academic medical center. With 603 beds, we serve as the region’s only tertiary care center and Level 1 Trauma Center, and are home to the Stony Brook Heart Institute, Stony Brook Cancer Center, Stony Brook Children’s Hospital, Stony Brook Neurosciences Institute, and Stony Brook Digestive Disorders Institute. We also encompass Suffolk County’s only Level 4 Regional Perinatal Center, state-designated AIDS Center, state-designated Comprehensive Psychiatric Emergency Program, state-designated Burn Center, the Christopher Pendergast ALS Center of Excellence, and Kidney Transplant Center. It is home of the nation’s first Pediatric Multiple Sclerosis Center.
Stony Brook University is an Affirmative Action/Equal Opportunity employer. We are committed to the creation of a diverse and inclusive campus climate. We encourage protected veterans, individuals with disabilities, women and minorities to apply.
This function/position has been 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.
Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at email@example.com .
IF YOU NEED A DISABILITY-RELATED ACCOMMODATION, PLEASE CALL THE UNIVERSITY HUMAN RESOURCE SERVICES DEPARTMENT AT (631) 632-6161 OR THE UNIVERSITY HOSPITAL HUMAN RESOURCES DEPARTMENT AT (631) 444-4700.
IN ACCORDANCE WITH THE TITLE II CRIME AWARENESS AND SECURITY ACT, A COPY OF OUR CRIME STATISTICS IS AVAILABLE UPON REQUEST BY CALLING (631) 632-6350. IT CAN ALSO BE VIEWED ON-LINE AT THE UNIVERSITY POLICE WEBSITE AT http://www.stonybrook.edu/police
Job Field: Other
Primary Location: US-NY-Stony Brook
Official Job Title: TH Staff Associate
Department/Hiring Area: Care Management
Stony Brook University Hospital
Pass Days: Day Shift
Posting Start Date: Oct 23, 2018
Posting End Date: Nov 22, 2018, 11:59:00 PM
Salary: Commensurate with experience
Salary Grade: SL4
Req ID: 1803389