Case Manager (RN or LPN)- Skilled Nursing

POMEROY Living Corporation; Sterling Heights (MI); Sur place; USD 70 000 - 90 000; Plein temps

Avantages offerts par ce poste

Paid Time Off

Paid Holidays

Access up to 50% of your earned pay DA

Company-paid Life insurance for FT

Priority Health Medical

Delta Dental

Vision Insurance

Résumé du poste

POMEROY Living Corporation in Sterling Heights and Rochester Hills is seeking a Registered Nurse or Licensed Practical Nurse to serve as Case Manager. This critical role connects residents, clinical teams, and managed care partners to coordinate care, support PDPM reimbursement, plan discharges, and ensure regulatory compliance.

You will advocate for resident rights, monitor authorizations, and work with the interdisciplinary team to optimize PDPM classification and minimize avoidable

Qualifications

• Active RN or LPN license in the State of Michigan in good standing.
• Minimum of 2 years of experience in case management, utilization review, managed care, or MDS within a skilled nursing or healthcare setting preferred.
• Working knowledge of PDPM reimbursement methodology, Medicare guidelines, and MDS 3.0 documentation preferred.
• Proficient computer skills and experience with Electronic Medical Records (EMR).
• Exceptional organizational, analytical, and interpersonal communication skills.

Responsabilités

• Drive positive resident outcomes by monitoring managed care authorizations, covered services, and approved lengths of stay.
• Serve as a key clinical advocate, communicating with payer representatives and the interdisciplinary team regarding care updates and continued stay reviews.
• Collaborate closely with nursing, therapy, and leadership to support accurate PDPM classification, diagnosis coding, and the triple-check process.
• Coordinate safe, efficient transitions of care and post-discharge services to support long-term recovery and minimize avoidable hospital readmissions.
• Ensure uncompromised regulatory compliance, upholding state and federal standards while safeguarding resident rights and dignity.

Connaissances

Case management coordination

Interdisciplinary communication

PDPM understanding

Regulatory compliance

Analytical skills

Outils

EMR software

Description du poste

Are you ready to be the driving force behind exceptional resident care and operational excellence? We are seeking a dedicated and impactful Registered Nurse (RN) or Licensed Practical Nurse (LPN) to step into an essential Case Manager role working across our Sterling Heights and Rochester Hills skilled nursing locations.

In this high-impact position, you will be the vital bridge between our residents, clinical teams, and managed care partners. By championing clinical coordination, accurate reimbursement support under the Patient Driven Payment Model (PDPM), seamless discharge planning, and strict regulatory compliance, you directly protect resident rights and ensure our community delivers top-tier, compassionate care. If you want your expertise, advocacy, and leadership to truly make a difference every single day, we want you on our team.

Key Responsibilities

• Drive positive resident outcomes by monitoring managed care authorizations, covered services, and approved lengths of stay.
• Serve as a key clinical advocate, communicating with payer representatives and the interdisciplinary team regarding care updates and continued stay reviews.
• Collaborate closely with nursing, therapy, and leadership to support accurate PDPM classification, diagnosis coding, and the triple-check process.
• Coordinate safe, efficient transitions of care and post-discharge services to support long-term recovery and minimize avoidable hospital readmissions.
• Ensure uncompromised regulatory compliance, upholding state and federal standards while safeguarding resident rights and dignity.

Qualifications & Requirements

• Active RN or LPN license in the State of Michigan in good standing.
• Minimum of 2 years of experience in case management, utilization review, managed care, or MDS within a skilled nursing or healthcare setting preferred.
• Working knowledge of PDPM reimbursement methodology, Medicare guidelines, and MDS 3.0 documentation preferred.
• Proficient computer skills and experience with Electronic Medical Records (EMR).
• Exceptional organizational, analytical, and interpersonal communication skills.
• Paid Time Off - start accruing day one of orientation
• Paid Holidays
• Access up to 50% of your earned pay DAILY!
• Company-paid Life insurance for FT staff
• Priority Health Medical, Delta Dental, and Vision Insurance