Regional Case Manager, Registered Nurse

Job overview

The Regional Case Manager, Registered Nurse role is based in Blountville, TN; compensation is not specified. The position supports Prestige Healthcare’s skilled nursing and rehabilitation services through regional managed-care coordination. The role maintains a caseload of managed-care patients, reviews clinical records, negotiates rates and levels of care, and coordinates authorizations and documentation. It connects regional and corporate managed-care initiatives with facility operations and clinical, therapy, finance, billing, sales, and marketing teams.

What you'll do

• Review managed-care contracts and clinical records
• negotiate rates, levels of care, exclusions, and one-time contracts
• obtain authorizations, reauthorizations, and notifications
• maintain case manager logs and required documentation
• communicate continued-stay documentation needs to centers
• participate in weekly facility reviews and monthly triple-check meetings
• train facility staff on pre-admission case management
• assist with managed-care audits
• travel as required by regional needs.

What we're looking for

Skills & competencies

regional case manager

registered nurse

case management

managed care

long-term care

medicaid

medicare

mds

clinical records

blountville tn

prestige healthcare

facility coordination

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, and vision coverage
• benefits concierge
• tuition reimbursement
• student loan repayment program
• company-paid life insurance
• paid vacation and sick time
• 401(k) match
• HSA and FSA
• referral bonuses.

Why this role

Five years of long-term-care managed-care experience is required; Registered Nurse and MDS experience are preferred. The posting describes a home-office/facility-based role with travel required.

About the employer

Prestige Administrative Services LLC is hiring for this role. Industry: All Other Miscellaneous Ambulatory Health Care Services. Sector: 62.