Post-Acute Care Transitions Manager (Remote)

PACS; United States; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health Coverage

PTO & Vacation

Retirement Planning (401(k))

Employee Assistance Plan (EAP)

Job summary

PACS is seeking a Reserved Bed Post-Acute Care Manager to act as the primary liaison between hospital partners and PACS post-acute centers. You will coordinate referrals, manage patient placement, maintain program metrics and reporting, and support program growth.

The role requires collaboration with hospital case management teams, adherence to admission criteria, documentation accuracy, and proactive communication to ensure smooth transitions and contractual compliance nationwide.

Qualifications

• Must possess, as a minimum, a high school diploma or GED.
• Bachelor’s degree in health care or related field preferred.
• Two (2) years of Admissions experience preferred.
• LVN or RN license required.

Responsibilities

• Educate hospital case managers on the Reserved Bed Program, referral criteria, and admission processes to facilitate efficient transitions of eligible patients into PACS post-acute care centers.
• Receive Reserved Bed referrals from hospital case managers and review patient records to determine eligibility in accordance with established admission criteria and stop-list guidelines.
• Manage the referral process in a timely and efficient manner by distributing referrals to participating PACS facilities, securing appropriate placement, and communicating placement outcomes to hospital case managers. Escalate unplaced referrals according to established escalation procedures.
• Assess patient financial and insurance resources, including Medicare, Medicaid, Managed Care, HMOs, and commercial insurance plans, to support appropriate placement recommendations and resource utilization.
• Coordinate patient transfers to PACS facilities by ensuring all required physician orders, clinical documentation, medications, equipment, and ancillary services are arranged prior to admission.
• Participate in required daily and weekly hospital case management meetings, interdisciplinary discussions, and committee meetings to strengthen partnerships and ensure program success.
• Maintain accurate and timely documentation of referrals, facility responses, admissions, denials, and patient placement outcomes within designated tracking systems.
• Monitor and manage the Reserved Bed census for assigned hospital partners to ensure compliance with contractual obligations and program expectations.
• Track, analyze, and report key performance indicators (KPIs) and operational metrics related to referral activity, admissions, denials, census utilization, and program outcomes.
• Develop and maintain professional, positive working relationships with hospital case management teams, physicians, PACS facility leaders, and other key stakeholders to support collaboration and program growth.
• Identify opportunities for process improvement and contribute to initiatives that enhance efficiency, patient outcomes, and customer satisfaction.
• Perform other duties and responsibilities as assigned.

Education

High school diploma or GED

Bachelor’s degree in health care or related field preferred

LVN or RN license required

Job description

PACS is seeking a Reserved Bed Post-Acute Care Manager to act as the primary liaison between hospital partners and PACS post-acute centers. You will coordinate referrals, manage patient placement, maintain program metrics and reporting, and support program growth.

The role requires collaboration with hospital case management teams, adherence to admission criteria, documentation accuracy, and proactive communication to ensure smooth transitions and contractual compliance nationwide.