Senior Discharge Plan Manager

UPMC • Pittsburgh, PA

5d

About The Position

The Senior Discharge Plan Manager coordinates and is accountable for patients’ post-discharge needs, while serving as a financial steward for the hospital. The role assesses relevant clinical and social factors, engages the care team, and focuses on timely, resource-conscious discharge planning. The manager reviews recommendations from different disciplines and coordinates the care needed to support positive outcomes outside the inpatient setting.

RNs and social workers function equally in discharge plan roles as central contacts throughout a patient’s care, partnering with a physician or APP. The Senior Discharge Plan Manager also provides training and mentorship to less experienced staff and participates in departmental operations and process improvement.

Requirements

• At least three years of experience in discharge planning or care coordination, which may include coordinating clinical care across settings, conducting insurance authorizations, obtaining information, and connecting patients with appropriate outpatient regional resources.
• RN candidates must have a BSN or 10 years of experience.
• RN candidates must have an RN license.
• Social worker candidates must have a master's degree in social work or another health or human services field that promotes the physical, psychosocial, and/or vocational well-being of those served.
• Social worker candidates must have an LSW/LCSW or other related healthcare professional license.

Nice To Haves

• CCM, ACM, or another nursing or social work certification.

Responsibilities

• Identify clinical, psychosocial, historical, financial, cultural, and spiritual needs that inform planning with patients, considering health literacy, understanding, engagement, patient preferences, goals of care, and social determinants of health.
• Complete and continually reassess patient assessments to understand medical and social factors, self-care capacity, support systems, discharge barriers, likely post-hospital service needs, service availability, and changes affecting the discharge plan.
• Facilitate teams in developing and executing safe, efficient discharges; maintain knowledge of local resources and providers; arrange post-hospital care before discharge; and help avoid unnecessary delays.
• Integrate patient goals, care-team assessments, risks, and available resources into successful transition plans.
• Communicate clearly with patients, members, caregivers, and the interdisciplinary care team, serving as a liaison between patients and the care team.
• Collaborate with attending practitioners, caregivers, and multidisciplinary team members to coordinate individualized care plans.
• Incorporate discipline-specific recommendations, test results, and outstanding orders into discharge plans; monitor and revise plans in response to discharge milestone progress.
• Serve as a contact between hospitals, post-hospital care facilities, and physicians who provide care in those settings.
• Share accountability with patients, caregivers, and team members for developing discharge plans that support optimal outcomes.
• Align practice with organizational mission, vision, and values; follow applicable ethical standards and codes of conduct; maintain clinical knowledge and ensure compliance with regulatory requirements.
• Advocate for patients and caregivers regarding access to services and protection of patients’ health, well-being, safety, and rights.
• Manage cost of care while considering patient safety, clinical quality, risk, and patient satisfaction.
• Use innovation and technology to improve collaboration and patient outcomes, and document care in the patient medical chart.
• Assist with departmental operations, including staff orientation, mentoring, and other issues.
• Demonstrate expertise in the relevant content area.
• Participate in process improvement initiatives.

Benefits

• Up to a $10,000 sign-on bonus for eligible roles with a two-year work commitment.
• A designated career ladder with tracks for nurses and social workers.
• Flexible schedule options.
• Up to 5 ½ weeks of paid time off and 7 paid holidays.
• $6,000 per year in tuition assistance.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior