Health Equity Manager-Case Management (Eastern Long Island)

Job Description - Health Equity Manager-Case Management (Eastern Long Island) (2401751)Health Equity Manager-Case Management (Eastern Long Island)Full-Time - Day ShiftsPosition Description:The Case Management (CM)/Health Equity Manager (HEM) will be responsible for the overall administration and operation of health equity and the case management department. The CM/HEM is responsible for the development, implementation, and evaluation of systems and processes related to health equity and case management, inclusive of utilization management. They will work collaboratively with the Social Work department in developing an organization wide health equity program, with the goal of meeting and sustaining the requirements for Joint Commission advanced certification. The CM/HEM is responsible for ensuring the department provides high quality, fiscally responsible and cost effective services that are responsive to the needs of the patients, families, and other members of the healthcare team. The CM/HEM is a member of the management team and reports directly to the VP for Quality and Regulatory Affairs.The CM/HEM will report to the VP for Quality and Regulatory Affairs and will work closely with the AVP for Quality.Responsibilities of the Case Management/ Health Equity Manager will include, but not be limited to the following:• Provide leadership in the development, implementation, and oversight for all aspects of case management to support patient centered care.• Oversight for the daily operations of the case management department to ensure quality patient care.• Direct the development and implementation of standards, systems, policies, and procedures in alignment with organizational strategic initiatives focused on quality and financial outcomes.• Ensure efficient resource utilization, quality outcomes, and maximization of reimbursement.• Collaborates with others in the organization to optimize compliance with regulatory and payer requirements and to promote the delivery of high quality, efficient, cost-effective, and appropriate care• Collaborates with the Business Office, other departments and insurance companies to ensure appropriate reimbursement• Ensures compliance with federal and state regulations, as well as established organizational policies and procedures• Develops analyses and reports of various activities to determine department progress toward stated goals and objectives• Provides oversight for medical necessity reviews, denials management, and utilization management supporting all areas of the organization• Fosters integration and strong clinical partnerships with hospitalists, physician advisors, and clinical integration activities in order to optimize care coordination, ensure efficient resource utilization, improve quality outcomes and enhance patient satisfaction• Maintains effective communication and a strong managerial presence with executive leadership, senior leaders, and internal and external organizations to coordinate and adequately address patient care needs.• Prepares, analyzes, and presents reports and recommendations to senior leadership regarding operations and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making. Develops, reviews, and monitors clinical, service and financial outcomes using performance metrics.• Advocate for and foster positive relationships with patients, families, and other members of the healthcare team• Serve as a resource to case managers regarding best practices and ethical decision-making.• Monitor staff performance and provide feedback and coaching to promote professional growth.• Collaborate with interdisciplinary team members to develop individualized treatment plans• Conduct ongoing documentation audits to ensure compliance with regulatory metrics.• Act as a liaison between the organization, the SBUH system and community-based organizations• Facilitate daily workflow to optimize the coordination of patient discharges.• Maintain a current knowledge base in the field of case management and health equity to ensure the department is providing evidence-based care.• In collaboration with Social Work and the healthcare system, coordinate, develop, implement and measure all aspects of health equity while moving toward advanced certification.• Attend and actively participate in various committees within SBELIH and SBUH• Manage special projects.• Oversee patient experience for the transition of care/discharge domain.• Acting discharge leader according to disaster planQualifications:Bachelor’s degree in nursingPRI and SCREEN certificationMinimum 7 years’ experience in Case ManagementExperience in Med/Surg./ICU/ EDExcellent written and interpersonal communicationProficient in WORD, EXCEL, and MCG guidelinesKnowledge of regulatory and accreditation requirementsPreferred:Master’s degree in nursing or related fieldLeadership experienceExperience in Health Equity- social determinants of HealthCase Management certificationSpecial Notes : Resume/CV should be included with the online application.Posting Overview : 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).If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later 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.• 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 Southampton Hospital and related facilities.Prior to start date, the selected candidate must meet the following requirements:• Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Southampton's Employee Health Services*• 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).Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.• The Human Resources department will be responsible for any fee incurred for examination .Stony Brook University Hospital, consistent with our shared core values and our intent to achieve excellence, remains dedicated to supporting healthier and more resilient communities, both locally and globally.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. With 70 beds, SBELIH is Suffolk County’s first hospital, serving the North Fork since 1905. SBELIH provides care to 25,000 year-round residents and expanding to 60,000 summer residents with comprehensive healthcare solutions, including behavioral health, medical-surgical, orthopedics and general surgery, wound care, interventional pain management and GI, advanced ambulatory care, diagnostic, and physical therapy services. The hospital is also a clinical campus and training site for Stony Brook Medicine, with its first SBELIH Psychiatry resident having graduated in 2022.StaffCo is a Professional Employer Organization, commonly referred to as a PEO. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Eastern Long Island employees and responsible for employment, including the day-to-day direction and supervision of work.StaffCo is fully responsible for providing all Payroll and Human Resource services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all benefits for which one is eligible. SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.Given StaffCo’s employment responsibilities, it is deemed the “employer” for employment and labor law purposes. Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY. The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board.Stony Brook Eastern Long Island Hospital is committed to excellence in diversity and the creation of inclusive learning, and a 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.Job Number:Job Number:2401751Job FieldJob Field: Quality and SafetyPrimary LocationDepartment/Hiring Area : Quality Services (Eastern Long Island)#J-18808-Ljbffr