Remote Regional Case Manager RN – Managed Care Expert

Medilodge of Rochester Hills, Inc.; Howell (MI); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Competitive Salary

Medical, Dental, Vision

401k with match

HSA/FSA

Tuition Reimbursement

Paid Vacation & Sick Time

Employee Benefits Concierge

Pet Insurance Options

Life Insurance

Referral Bonuses

Job summary

Prestige Healthcare seeks a Regional Case Manager (RN) to manage a caseload of long-term care patients, review clinical records, and negotiate rates with managed care organizations. This remote role links regional and corporate initiatives and collaborates with Operations, Marketing, and Finance to implement managed care processes.

The ideal candidate has RN credentials, 5 years in long-term care managed care, and a background in MDS. Remote work with competitive benefits is offered.

Qualifications

• Registered Nurse preferred.
• Five years of long-term care managed care experience.
• Background in MDS preferred.

Responsibilities

• Review all managed care contracts for facilities.
• Negotiate rates, levels and exclusions with managed care organizations.
• Coordinate with regional staff and Director of Managed Care for consistency.
• Obtain authorizations and re-authorization for new managed care patients.
• Maintain Case Manager log daily and communicate required documentation.

Skills

Registered Nurse

Case Management

Long-term care

MDS

Medicaid & Medicare

Excel

Microsoft Word

Education

Registered Nurse

Tools

Excel

Microsoft Word

Job description

Prestige Healthcare seeks a Regional Case Manager (RN) to manage a caseload of long-term care patients, review clinical records, and negotiate rates with managed care organizations. This remote role links regional and corporate initiatives and collaborates with Operations, Marketing, and Finance to implement managed care processes.

The ideal candidate has RN credentials, 5 years in long-term care managed care, and a background in MDS. Remote work with competitive benefits is offered.