Hiring: Case Manager Company: Stony Brook Medicine Location: Stony Brook, NY Job Posted Time: 2026-09-16 20:20:07 Employment Type: Full-time Target Skills & Keywords : CV, EMR, Medicare, Utilization Review About the job Experience: •5 years in hospital setting. A candidate should have a good understanding of the admission/discharge process. They need good interpersonal skills to work with all team members. They need to document accurately and be able to prioritize their work and follow up with cases. Required Skills: •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. •All Medicare cases are reviewed for level of care on admission. Reviews with the Attending, any patient who does not meet in-patient criteria for admission. Follows the process for Code 44 on Medicare patients. Follow the process for Code 44 on all other payers. •Active participation with the physician and payer to prevent denials. Reviews cases for potential change in level of care with the CM and physician. •Communicates with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer from other hospitals. •Consistent documentation in the EMR regarding acuity, plan of care and communication with the team. Charting includes data for authorization and data management. •Reviews cases daily from admission through discharge to prevent denials. •This includes patient and family contacts, insurance authorizations, tests, procedures, community resources etc. •Assistants with coordination for discharge planning including patient and family education with the interdisciplinary team. Coordinates transitional care planning for outpatient resources, prepares PRI for early referrals and contacts with agencies and facilities throughout the hospital stay. Qualifications: •CM, UM, Quality, Coding, Risk or MCG Certification Working knowledge of MCG or Interqual PRI Certified Knowledge of regulatory requirements Bilingual Recent experience in tertiary care Experience in pediatrics, NICU, Mother/Baby or ED Leadership skills Master’s prepared. •Verification of degree (e.g., diploma or official transcript) is required for this role. Upload of documentation must be included with your application for consideration. •Resume/CV should be included with the online application. •This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date). •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. Compensation: •$92,902 - $132,454 / year Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!