Remote RN Regional Case Manager: Managed Care Leader

Medilodge; Lansing (MI); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical, dental & vision benefits

Tuition reimbursement

Student loan repayment

Company-paid life insurance

401k with match

HSA & FSA options

Paid vacation with rollover & sicktime

Unlimited referral bonuses

Job summary

Medilodge is seeking a Regional Case Manager (RN) to oversee a caseload of managed care patients across facilities. You will review clinical records, negotiate rates and exclusions, and coordinate with operations, marketing, and finance to implement managed care processes.

The role requires RN background with strong experience in long-term care and MDS, and involves collaboration with regional and center staff to ensure compliance and optimal patient care.

Qualifications

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

Responsibilities

• Review managed care contracts for their facilities to ensure alignment with regional goals.
• Negotiate rates, levels and exclusions with managed care organizations.
• Obtain authorization and re-authorization for new patients and activity.
• Maintain Case Manager Log daily and communicate needs for documentation to centers.

Skills

Case Management

RN experience

Excel

Microsoft Word

Education

RN preferred

Job description

Medilodge is seeking a Regional Case Manager (RN) to oversee a caseload of managed care patients across facilities. You will review clinical records, negotiate rates and exclusions, and coordinate with operations, marketing, and finance to implement managed care processes.

The role requires RN background with strong experience in long-term care and MDS, and involves collaboration with regional and center staff to ensure compliance and optimal patient care.