Merakey Jobs

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 forLevel of Care i.e. Inpatient, Observation, Emergency and other outpatientservices.
• Coordination of Carewith Interdisciplinary team.
• Resource Management-including capturing Avoidable Days, over utilization of services, etc.
• DischargePlanning Activities which includes communication with theinterdisciplinary team, patient and/or significant other, earlycoordination with post-acute providers.
• Develop and documentAssessment, Patient Progress Note and Transitional Care Plan.
• Retrospective reviewswhen needed for short stay admissions.
• Active participationwith insurance and physician to avoid denials and/or work to reversenegative denial decisions from payer.
• Reviewall admissions for appropriate level of care.
• Communicate withphysicians, transferring hospitals, payers, admitting for authorizationprior to transfer.
• Prepare PRI,departmental forms, ensure education of patient and family with accuratedocumentation throughout hospital stay and at discharge.
• Active participation inperformance improvement, department activities and data collectionefforts.
• Always maintain a highlevel of customer service.

Required: 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.

Preferred: 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.

• 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).