Job Description

Program Manager, Discharge Planning - HSO Skilled Nursing Facility - Corporate Office - Full time Days

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

Responsibilities

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

Qualifications

Education requirements:

• Bachelor?s Degree

Experience requirements:

• 5-7 years of experience in health care setting. Health plan or post-acute care experience preferred.

Non-Bargaining Unit, M1T - HSO SKILLED NURSING FACILITY TRANSFERS - MSH, Mount Sinai Hospital