Remote RN Regional Case Manager – Managed Care Leader

Medilodge of Rochester Hills, Inc.; Kalamazoo (MI); On-site; USD 75,000 - 105,000; Full time

Benefits offered by this job

Competitive Salary

Medical, Dental and Vision benefits

401k with company match

Tuition reimbursement

Paid vacation and sick time

Job summary

Prestige Healthcare is seeking a Regional Case Manager (RN) to oversee managed care patients in long-term care settings. The role emphasizes strong case management, contract negotiation, and coordination with regional and corporate teams.

The ideal candidate has extensive LTC managed care experience, MDS knowledge, and a solid RN background to ensure compliant, efficient patient care across regions.

Qualifications

• Registered Nurse preferred with case management experience in long-term care.
• Five years of managed care experience in long-term care; background in MDS preferred.
• Knowledge of Medicaid/Medicare processes and managed care contracts.

Responsibilities

• Review managed care contracts executed for their facilities.
• Negotiate rates, levels and exclusions with managed care organizations.
• Obtain authorizations and notifications for new managed care patients.
• Maintain the Case Manager Log daily.
• Collaborate with Sales, Marketing, Business Office, Therapy, and Clinical teams.

Skills

RN license

Case management

MDS knowledge

Medicaid/Medicare

Education

RN preferred

Tools

Excel

Microsoft Word

Job description

Prestige Healthcare is seeking a Regional Case Manager (RN) to oversee managed care patients in long-term care settings. The role emphasizes strong case management, contract negotiation, and coordination with regional and corporate teams.

The ideal candidate has extensive LTC managed care experience, MDS knowledge, and a solid RN background to ensure compliant, efficient patient care across regions.