Mount Sinai Health System · 1 day ago
Program Director (Utilization Management) Licensed - Mount Sinai Health Partners
New York, NY
Full-time
Onsite
Director/Executive
$132K/yr - $210K/yr
7+ years expMount Sinai Health System is one of the largest academic medical systems in the New York metro area, and they are seeking a Program Director (Utilization Management) to lead and sustain a Utilization Management Initiative. This role involves driving cost-effective, high-quality post-acute care through strategic partnerships and performance oversight across a network of skilled nursing facilities.
Health CareHospitalMedical
Responsibilities
Lead, expand, and sustain the SNF Utilization Management Initiative across a network of 90+ SNF partners
Support post-acute clinical coordinators by escalating to SNF leadership to expedite patient discharge when clinically appropriate and safe
Ensure continuity of program operations during staffing changes through cross-training and workflow optimization
Monitor ACO and value-based contract performance using Tableau dashboards, CarePort Insight, and internal reporting tools
Develop, refine, and implement performance improvement strategies to ensure SNFs meet or exceed target benchmarks
Deliver comprehensive monthly performance reports to executive leadership, including the VP of Care Transitions and CMO
Track and report on key performance indicators (KPIs), including utilization, length of stay, discharge disposition, and preferred provider use
Oversee utilization management strategies to ensure appropriate levels of care at discharge
Maintain reduced Certified Home Health Agency (CHHA) utilization rates, matching or exceeding organizational benchmarks
Collaborate with payers and SNF leadership to ensure appropriate authorization processes and optimized lengths of stay for short-term skilled services
Provide clinical oversight to Transitional Care Coordinators to ensure appropriate discharge planning and higher rates of home discharge
Support and optimize workflows, documentation, and reporting within Epic
Ensure staff adherence to standardized workflows, clinical appropriateness, and regulatory requirements
Maintain and strengthen partnerships with skilled nursing facilities, part B vendors, CHHAs, long-term home care agencies and hospice providers
Lead Joint Operating Committee (JOC) meetings and provide ongoing performance updates and ad-hoc consultations
Sustain strong payer relationships to support utilization management goals
Monitor and report on ACO discharges to preferred vs. non-preferred SNFs
Share performance feedback with hospital leadership to reinforce preferred provider utilization
Lead in-person and virtual education sessions for social workers, case managers, and interdisciplinary inpatient teams
Develop and maintain orientation and educational materials focused on:
Discharge to home
Preferred provider utilization
Available transitional care resources (e.g., TOCC/NCC)
Lead rapid operational restructuring in response to staffing or organizational changes
Develop and maintain training materials, tip sheets, disclaimers, and Epic-integrated resources
Partner with Communications to ensure initiatives are accurately represented internally and externally
Evaluate workflows and processes continuously to improve efficiency, productivity, and outcomes
Foster a culture of openness, trust, inclusivity, and accountability
Lead monthly team meetings and individual check-ins to align goals and co-create performance strategies
Train, retrain, and onboard staff to new workflows, ensuring operational stability during transitions (e.g., leaves of absence)
Provide constructive feedback, coaching, and hands-on support to drive high performance and engagement
Support staff cross-training to ensure adequate coverage and continuity of care
Qualification
Required
Master's or greater in Nursing, Bachelor's or greater in Physical Therapy or Occupational Therapy
7+ years of experience in care management, utilization management, population health, or value-based care
Demonstrated experience working with ACOs, SNFs, and post-acute care networks
Current NYS licensure (Nursing, Physical Therapy, Occupational Therapy or related profession)
Demonstrated interpersonal and leadership and organizational skills
Analytic ability to collect and organize information, identifies problems and trends, and formulate and implement corrective plans and programs
Ability to develop, coordinate, prioritize and allocate resources
Proven ability to lead complex initiatives with limited resources
Excellent communication, relationship-building, and presentation skills
Advanced MS Office Suite Skills
Company
Mount Sinai Health System
Mount Sinai Health System delivers integrated medical care, research, and medical education through its network.
10001+ employees
H1B Sponsorship
Mount Sinai Health System has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (5)
2024 (3)
2023 (26)
2022 (20)
2021 (6)
2020 (20)
Funding
Current Stage
Late StageTotal Funding
$41.9MKey Investors
National Institutes of HealthHearst Health Prize.Multiple Myeloma Research Foundation
2024-11-11Grant· $7M
2024-06-06Grant· $0.1M
2023-11-02Grant· $7M
Leadership Team
Vincent Tammaro
Executive Vice President and Chief Financial Officer
David Feinberg
Senior Vice President, Chief Marketing and Communications Officer
Recent News
Digital Journal
2026-01-08
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