RN/LPN Case Manager – PDPM & Care Transition Lead

POMEROY Living Corporation; Sterling Heights (MI); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

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

Job summary

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.

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.

Skills

Case management coordination

Interdisciplinary communication

PDPM understanding

Regulatory compliance

Analytical skills

Tools

EMR software

Job description

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