Post Acute Placement Assistant

The Post Acute (PAC) Placement Assistant ensures safe, timely patient flow from the VCU Medical Center to the appropriate post acute destination by coordinating essential information and communication across care teams and external providers. This role supports RN Care Coordinators, Authorization Specialists, RN Case Managers, and Social Workers by organizing patient and insurance details and facilitating efficient discharge planning. Through managing complex, time sensitive placements, the position helps prevent readmissions and promotes continuity of care across the post acute continuum.

Post-acute services include, but are not limited to:
• Home Health Agencies
• Hospice Services
• Skilled Nursing Facilities (SNFs)
• Inpatient Rehabilitation Facilities (IRFs)
• Long-Term Acute Care Hospitals (LTACHs)

Essential Job Statements

Post Acute (PAC) Placement Operations and Processing:

Manage all components of post-acute placement procedures to completion for seamless follow-up care post hospitalization. Manage a daily caseload of 20–30 patients, prioritizing tasks to meet discharge deadlines. Proactively address PAC placement challenges using sound judgement and independent thinking. Collaborate with interdisciplinary teams to promote continuity of care and optimal patient outcomes. Coordinate the communication and referrals to post-acute providers including home health, home and inpatient hospice, Long Term Acute Care facilities, Skilled Nursing facilities, Assisted Living facilities, DME, transportation and any other type of post discharge provider of services required. Support Post Acute RN Care Coordinators, Post Acute (PAC) Authorization Specialists, Inpatient RN Case Managers (RNCCs) and Inpatient Social Workers (SWs) in all aspects of discharge planning to ensure smooth and timely patient transitions from VCUMC.

Health Information Technology and Data Management:

Prepare, upload, and transmit referrals to appropriate post-acute care settings using referral management software and Electronic Medical Record. Track and electronically save all PAC placement and eligibility documents and progress. Examine EMR for data to assist with timely PAC placements. Upload and maintain documentation in Referral Management portal and the electronic medical record (EMR) system as new info comes available. Leverage technology to streamline placement and improve communication. Organize tracking, prioritizing, and reporting outcomes of PAC placement requests. Collect data and summarize as needed for managerial decision support and performance improvement endeavors

Documentation & Clinical Submission:

Act as a liaison between inpatient care coordinators and post-acute facilities/agencies to optimize PAC placement timeline and hit aggressive discharge targets. Practice meticulous data entry, rigorous proofreading, systematic filing, compliance monitoring, and verifying information precision to prevent errors. Assure submission of accurate requests by creating checklists, auditing documents, and maintaining structured records. Maintain and update departmental trackers and documentation systems for accurate and timely recordkeeping.

Post Acute Service Verification:

Understand and practice by organizational and PAC network policies and procedures for successful PAC placements. Stay updated on post-acute facility capabilities, community resources, and insurance/coverage by market. Ensure patient eligibility and coverage details are accurate for timely PAC access. Assist care coordinators, patients, and PAC co-workers in understanding PAC placement eligibility including insurance company denials, as applicable. Assure arranged post-acute care meets patient discharge needs and supports individualized care plans and goals set with the patient and family.

Communication & Coordination:

Maintain and communicate strong working knowledge of hospital processes, discharge planning, and post-acute care settings. Assume responsibility for all assigned patient PAC placements by collecting and recording accurate patient information and coordinating with all stakeholders. Handle high-volume inbound/outbound messages/calls with PAC representatives and staff regarding timeline and details regarding PAC services. Address, track, and communicate with physicians/care coordinators regarding missing information in PAC placement files. Communicate in timely manner with Care Coordination employees, Post Acute RN Care Coordinators, and vendors regarding authorized PAC services once placement is verified. Communicate directly with PAC facility liaisons to confirm patient acceptance, coordinate logistics, and resolve placement issues.

Escalate complex PAC placement issues and/or care delays to Continuum Integration leadership.

Administrative