Program Manager, Discharge Planning-HSO SKILLED NURSING FACILITY TRANSFERS -150 East 42nd Street - Full-Time-Day shift-9A-5P

Mount Sinai Health Systems•New York, NY

2d•$65,885 - $106,891•Onsite

About The Position

The Program Manager, Discharge Planning facilitates successful discharge plans that support length-of-stay (LOS) reduction and patient flow. The role locates resources and rapidly responds to requests from Case Management, Social Work, and unit staff. It works closely with Care Management and Social Work to support proper and timely discharges, ensures discharge-plan details are communicated to the interdisciplinary treatment team, collaborates daily with skilled nursing facilities on patient placement and throughput, and works with the contracting team to obtain timely authorizations. The position provides operational oversight of the discharge-planning team and program, supporting patient throughput, patient care, and unit and clinical-service objectives. It manages discharge planning resources and processes, maintains relationships with post-acute providers and insurance payors, and coordinates referrals, authorizations, and patient transfers. The manager tracks authorization delays and payer-related LOS delays and reports relevant information to leadership, contracting, and billing teams.

Requirements

Bachelor’s degree.
5–7 years of experience in a health care setting.

Nice To Haves

Health plan experience.
Post-acute care experience.

Responsibilities

Provide operational oversight to the discharge-planning team and ensure day-to-day activity supports patient throughput and excellent patient care.
Attend senior leadership meetings to strategize, present data, and implement process improvements related to length of stay and excess days.
Manage discharge planning and facilitate discharge plans to support LOS reduction and patient flow.
Manage resources, respond rapidly to requests from Case Management, Social Work, and unit staff, and offer insight when needed.
Maintain contact with unit case managers and social workers regarding timely documentation, patient choice, and accepting facilities.
Ensure the Discharge Planning Unit program supports patient, unit, and clinical-service objectives.
Develop and maintain relationships with post-acute providers and insurance payors.
Attend meetings with post-acute care provider leads to discuss key performance indicators.
Prepare discharge-planning packets for appropriate post-acute services and secure post-acute care beds in a timely manner.
Send clinical information to insurance companies and post-acute care providers through ACM for discharge planning and authorization.
Use and optimize the Allscript platform for timely referrals, authorizations, and patient transfers.
Keep health plan address book and Allscript platform information up to date.
Clarify covered benefits with insurance providers and obtain authorization numbers for post-acute services.
Coordinate patient transportation with the command center.
Log difficult cases, including the number of days authorization was delayed and the reason for the delay.
Report daily to the contracting team and executive director the number of patients waiting for authorization by payer.
Provide the contracting team and billing department with documentation supporting discharge billing delays related to authorization delays or network inadequacy by payer.
Report monthly on LOS by payer and the total number of delay days contributing to excess days.