Long Island Community Hospital has served this richly diverse region as a patient-first community hospital for more than 60 years. As Long Island’s only independent community hospital, we are 100% committed to becoming the community’s healthcare provider of choice with our greatly enhanced services including the Knapp Cardiac Care Center, our highly-advanced heart disease diagnosis and treatment facility, our new modern surgical pavilion, our unique ER approach, and our high-touch services including women’s imaging, sleep laboratory and orthopedics and more. These services are delivered with the highest level of compassion by our LI Community Hospital staff – Long Islanders with an unmistakable mix of courage and heart who care about the people right here in our community and whose sole purpose is to provide personalized comfort.
The Care Manager’s focus will be primarily Utilization Management. The Care Manager will collaborate with physicians, physician assistants, nurse practitioners and case managers to ensure proper documentation to demonstrate medical necessity for patient’s admission and continued stay at Long Island Community Hospital. Documentation is performed in accordance with current regulatory guidelines with the use of recognized best practice guidelines for medical necessity. This care manager will have the responsibility to complete clinical reviews on all patients regardless of the payer source and also review Observation patients to ensure appropriateness of the level of care and admission status. This is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes. This Care Management position maintains ongoing education and training with the clinical documentation initiative program. This Care Manager will be a part of the Utilization Committee and may speak to medical necessity admissions and extended stays, appropriateness of setting and medical necessity of professional services.
Appraising performance involves observing and evaluating an employee's work behavior and accomplishments with the purpose of measuring there job performance against expected performance. Performance evaluation can be a powerful tool for individual and organization growth because it helps us to develop staff and move us closer to achieving the Hospital's goals. It also recognizes and rewards an employe's contributions, motivates them to maximize their potential and when necessary lets the employee know when improvement in performance is needed in a particular aspect of his/her job.
Current NYS Registered Nursing License. B.S or M.S. preferred
Case Management certification from accepting accrediting body, preferred
Minimum 5 years of clinical medical-surgical experience and 3-5 years experience as a hospital in-patient Case manager
Must possess knowledge of Federal and State regulations pertaining to hospital reimbursement, the utilization review process and the discharge planning function
Knowledge of identification, assessment, and intervention pertaining to high-risk populations
Working knowledge of/completion of CDI-Clinical Documentation Implementation Training
Working knowledge/experience with hospital/care management software, documenting electronically, and compiling data from the electronic medical record
Working knowledge of Microsoft outlook, Microsoft Word, Excel, Power Point, and scanning
PRI and Screen certifications, preferred.