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About the Role

The Program Manager, Discharge Planning facilitates successful discharge plans which are critical to LOS reduction and patient flow. This role locates resources, rapidly responds to requests by Case Management, Social Work, and Unit Staff, and works closely with Care Management and Social Work to assure proper and timely discharge of patients. Ensures communication of discharge plan details to the interdisciplinary treatment team and collaborates with skilled nursing facilities daily to ensure patient placement and throughput. Collaborates with the contracting team to ensure timely authorizations are obtained for patient discharge.

Responsibilities

Provides operational oversight to the discharge planning team to ensure day-to-day activity supports optimum patient throughput and excellent patient care.
Attends and participates in meetings with senior leadership to strategize, present data, and implement process improvement around length of stay and excess days.
Manages the successful discharge planning process and facilitates discharge plans, critical to LOS reduction and patient flow.
Responsible for managing resources, rapidly responding to requests by Case Management, Social Work, and Unit Staff, and offering insight when needed.
Maintains contact with the unit case manager and social worker regarding timely provision of documentation and patient choice and accepting facility.
As manager of the program, ensures the overall Discharge Planning Unit program supports patient, unit, and clinical service objectives.
Facilitates new and maintains current relationships with post-acute providers and insurance payors.
Attends and participates in meetings with post-acute care provider leads to discuss key performance indicators.
Prepares all discharge planning packets for appropriate post-acute services and secures PAC bed in a timely manner.
Sends clinical information to insurance companies and PAC through ACM for discharge planning and authorization.
Leverages and optimizes the Allscript platform to ensure timely referrals, authorization, and patient transfers.
Responsible for maintaining the health plan address book and Allscript platform information up-to-date.
Verifies/Interacts with Insurance: clarifies covered benefits, contacts providers, and obtains authorization numbers for insurance companies for post-acute services.
Coordinates with the command center for patient transportation.
Keeps a log of difficult cases, noting the number of days authorization was delayed and the reason why.
Reports daily to the contracting team and executive director the number of patients waiting for authorization by payer.
Provides documentation to support delay in discharge billing related to authorization delay or network inadequacy issues by payer to the contracting team and billing department.
Reports monthly on LOS by payer and total number of day delays contributing to excess days.

Requirements

Bachelor’s Degree.
5-7 years of experience in a health care setting.
Health plan or post-acute care experience preferred.

Location

East 42nd Street

Work Type

Full-Time
Day shift

Experience Level

5-7 years

Education Level

Bachelor’s Degree

Salary/Compensations

$65,885.00 - $106,891.29 Annually

About the Company

The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual.
At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history.
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

Equal Opportunity

The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization.