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.

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.

• 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.

• 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).