RN Case Manager- Per Diem

About the role

A TH Staff Associate/Case Manager at Stony Brook Medicine provides clinical services to our patient population. Key responsibilities include completing utilization reviews, ensuring patients are placed in the correct level of care, reviewing cases for potential changes in level of care, and coordinating discharge planning.

Responsibilities

• Completes Utilization review screen for inpatient and observation cases.
• Works closely with Case Managers and Social Workers on the units.
• Ensures patients are placed in the correct level of care from initial assessment.
• Follows cases for authorization for inpatient stays.
• Reviews short stay, long stay, and complex cases to develop safe discharge plans.
• Completes retrospective reviews and other projects as assigned.
• Identifies avoidable delays in the Care Management Program and documents them.
• Reviews and documents on patients who were readmitted within thirty days.
• Documents overutilization of resources and services.
• Reviews Medicare cases for level of care on admission.
• Follows the process for Code 44 on Medicare and other payers.
• Communicates with transferring hospitals, Patient Access, and payers for authorization prior to transfers.
• Consistently documents in the EMR regarding acuity, plan of care, and communication with the team.
• Coordinates transitional care planning for outpatient resources and prepares PRI for early referrals.
• Participates actively in performance improvement activities including program development, data collection, and analysis.
• Maintains high-level customer service.
• Assists with unit coverage as needed and other duties as required.

Qualifications

• A Bachelor’s degree or a nurse working on their degree with an RN license and working history of 5 years in hospital setting.
• A good understanding of the admission/discharge process.
• Good interpersonal skills to work with all team members.
• The ability to document accurately and prioritize work.
• Preferred: CM, UM, Quality, Coding, Risk or MCG Certification.
• Working knowledge of MCG or Interqual PRI Certification.
• Knowledge of regulatory requirements.
• Recent experience in tertiary care.
• Experience in pediatrics, NICU, Mother/Baby, or ED.
• Ledership skills.
• Master’s prepared.

Benefits

Stony Brook Medicine offers a comprehensive benefits package including health plans, state pension, generous leave, and more. Details are available upon request.

Pay

The starting salary range (or hiring range) for this position has been established as $76.50/hr. The specific salary offer will be based on the candidate’s validated years of comparable experience.

Schedule

This position is per diem.

Posting End Date

The posting end date is September 10, 2026, 3:59:00 AM.