Position Summary: The Case Manager (CM) provides all aspects of discharge planning and utilization review activities for an identified group of patients. The CM is responsible for assessing the patient’s physical, social and mental wellness needs, and preferences and abilities in planning, directing, implementing and coordinating a comprehensive discharge plan. The CM works within the interdisciplinary team and oversees the development of coordinated, integrated and individualized care plans and discharge plans. The CM is responsible for coordinating services with other post‑acute care providers and community‑based organizations. The CM assists patients in making informed decisions by acting as their advocate regarding their clinical status and treatment options. The CM is responsible for coordinating care that is safe, timely, effective, efficient, and equitable and client centered.
Job Duties & Essential Functions
Addresses the special needs of each age group served and assists in making reasonable accommodations for the hearing/visually impaired, physically challenged, or any other patient who may require services.
Assesses the patient’s physical and mental and social wellness needs, preferences and abilities of patients to assist in planning, directing, implementing and coordinating a comprehensive discharge plan.
Demonstrates appropriate understanding of the needs of patients and visitors for each specific age group.
Monitors inpatient and outpatient (MIP/MOB) cases for quality of care with focus on aspects of care and indicators.
Utilizes MCG and Navi‑health/Careport software to assist in level of care determination and discharge planning.
Identifies quality of care concerns that may require immediate action and/or reporting.
Works within the interdisciplinary team and oversees the development of coordinated, integrated and individualized care plans and discharge plans.
Assists patients in making informed decisions by acting as their advocate regarding their clinical status and treatment options.
Effectively coordinates services and other post-acute care providers and community-based organizations.
Coordinates care that is safe, timely, effective, efficient, equitable and client centered.
Assures confidentiality of all information.
Maintains appropriate documentation of all patient care activities.
Communicates and collaborates effectively with others.
Serves as a resource for Medical and Hospital Staff.
Provides timely concurrent and retrospective clinical reviews to insurance companies.
Makes appropriate and timely referrals to insure appropriate continuing care based on needs.
Monitors patient’s progress towards discharge and communicates issues identified to appropriate members of interdisciplinary team.
Acts as a resource and leader to interdisciplinary team.
Accurately documents status on PRI and SCREENS.
Maintains professional ties with appropriate outside professional groups.
Maintains ethical relationships.
Adheres to hospital and departmental rules and regulations.
Participates in in‑service programs.
Participates in annual recertification training, compliance training, HIPAA training.
Perform all other related duties as assigned by management.
Required Experience & Qualifications
Registered Professional Nurse currently licensed in NYS required.
Experience in Utilization Management (InterQual and/or MCG), Performance/Quality Improvement and D/C Planning required.
Critical thinking, ability to multitask and problem solve.
Compassionate with teamwork skills.
Excellent verbal and written/electronic communication skills.
Preferred Experience & Qualifications
One (1) to two (2) years case management experience in an acute hospital setting preferred.
Physical Demands
Good vision and hearing.
Maintain physical and mental capabilities to perform work related duties.
Special Notes
Resume/CV should be included with the online application.
Anticipated Pay Range
The starting salary range (or hiring range) for this position has been established based on relevant experience. The above salary range (or hiring range) represents SBEILH’s good faith and reasonable estimate of the range of possible compensation at the time of posting. Your total compensation goes beyond the number in your paycheck!
Pre‑Employment Requirements
Successfully complete pre‑employment physical examination and obtain medical clearance from Stony Brook Eastern Long Island’s Employee Health Services.
Complete electronic reference check with a minimum of three (3) professional references.
Successfully complete a 4 panel drug screen.
Meet regulatory requirements for pre‑employment screenings.
Provide a copy of any required New York State license(s)/certificate(s).
Company Overview
As part of Stony Brook Medicine, Stony Brook Eastern Long Island Hospital (SBELIH) combines the best in academic and community medicine, improving access to advanced medical care for residents of the North Fork and Shelter Island. SBELIH is Suffolk County’s first hospital, serving the North Fork since 1905, with a capacity of 70 beds and expanded services to 60,000 annual residents.
Equal Opportunity Employer
Stony Brook Medicine 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.