Case Manager- Part Time Temporary

Case Manager – Part Time Temporary (2502432) Position Summary

At Stony Brook Medicine, a TH Staff Associate/Case Manager is a valuable member of our team, providing 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.

• Complete utilization review screen for inpatient and observation cases, including UR from ER or on unit to ensure guidelines are reviewed and plan of care discussed with the team.
• Work closely with Case Managers and Social Workers on units and review findings with them, ensuring patients are placed in correct level of care from initial assessment and following cases for authorization for inpatient stay.
• Review short stay, long stay, and complex cases to ensure a safe discharge plan. Complete retrospective review, one and two day short stay reviews, and other projects as assigned. Identify, follow and document avoidable delays in Care Management Program.
• Document cases readmitted within thirty days and over utilization of resources and services.
• Review all Medicare cases for level of care on admission; follow process for Code 44 on Medicare and other payers.
• Participate actively with physician and payer to prevent denials and review potential changes in level of care with CM and physician.
• Communicate with transferring hospital, Patient Access, physicians and payers for authorization prior to transfer.
• Consistent documentation in the EMR regarding acuity, plan of care, and communication with the team. Charting includes data for authorization and data management.
• Review cases daily from admission through discharge to prevent denials, covering patient/family contacts, insurance authorizations, tests, procedures, community resources, etc.
• Assist with coordination for discharge planning, including patient and family education with interdisciplinary team, coordinate transitional care planning for outpatient resources, prepare PRI for early referrals and contacts with agencies and facilities throughout hospital stay.
• Actively involved in performance improvement activities such as program development, data collection and analysis.
• Maintain high level of customer service.
• Provide unit coverage as needed and perform other duties as required.

Required: Bachelor’s degree or a nurse working toward a degree with an RN license and at least 5 years of hospital experience. Good understanding of admission/discharge process, strong interpersonal skills, accurate documentation, prioritization, and follow-up of cases.

Preferred: CM, UM, Quality, Coding, Risk or MCG certification; working knowledge of MCG or Interqual; PRI certification; knowledge of regulatory requirements; bilingual; recent tertiary care experience; experience in pediatrics, NICU, Mother/Baby or ED; leadership skills; master’s degree.

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 .

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