Ambulatory Care Management

Enhancing Healthcare for Patients and their Families

Customized Plans for your patients

The CIN Care Management Team is an interdisciplinary team of health professionals, including Nurses, Health Navigators and Social workers, that covers the footprint of Stony Brook Medicine. We engage patients and their families to provide free health education, health system navigation, as well as resource and referral linkage in the context of several care models. 

We do not bill for our services. The work of Care Management is very much mission and vision critical, helping the enterprise thrive in value-based arrangements.  As we continue to grow our team, we will be able to further innovate and support the needs of Stony Brook Medicine and the communities it serves.

ED Treat and Release Management

Capture timely and appropriate surveillance for at risk patients recently discharged from the Emergency Department

Transitional Care Management

Reduce readmission rates and improve post-acute care recovery for recently discharged high risk patients with an integrated care management plan that addresses the whole individual.

Complex Care Management

Target risk reduction and optimize wellness by addressing the wide range of clinical and psychosocial needs of your high risk, medically complex patients.

Advanced Illness Management

Apply predictive AI to identify patients who would benefit from palliative care, focusing on chronic symptom management and maintaining quality of life.

Post-Acute Care Service Coordination

Coordinate and influence the progression of care with the Skilled Nursing Facilities, Home Health and Hospice agencies caring for your patient.

To learn more, contact:

April Feld, DNP, RN, CCM, CPHQ
Director Ambulatory Care Management
Clinically Integrated Network
500 Commack Road, Suite 170
Commack, NY, 11725

Telephone: (631) 638-1814

Email: April.Feld@stonybrookmedicine.edu

For providers only: Referrals can be sent to CINCareManagement@stonybrookmedicine.edu or through the main Cerner Message Pool (Ambulatory CM Referral Pool), which is managed Monday through Friday, 8:30 am to 4:30 pm.
Last Updated
06/24/2022