Case Manager (RN or LPN)- Skilled Nursing

Pomeroy Living • Sterling-Heights, MI

4d

About The Position

The Case Manager works across the Sterling Heights and Rochester Hills skilled nursing locations, serving as a clinical link between residents, clinical teams, and managed care partners. The role supports resident care and operational excellence through clinical coordination, reimbursement support under the Patient Driven Payment Model (PDPM), discharge planning, and regulatory compliance. The Case Manager advocates for residents while helping ensure compassionate care, protection of resident rights, and effective transitions of care.

Requirements

• Active RN or LPN license in the State of Michigan in good standing.
• Proficient computer skills and experience with Electronic Medical Records (EMR).
• Exceptional organizational, analytical, and interpersonal communication skills.

Nice To Haves

• At least 2 years of experience in case management, utilization review, managed care, or MDS within a skilled nursing or healthcare setting.
• Working knowledge of PDPM reimbursement methodology, Medicare guidelines, and MDS 3.0 documentation.

Responsibilities

• Monitor managed care authorizations, covered services, and approved lengths of stay to support positive resident outcomes.
• Communicate care updates and continued stay reviews to payer representatives and the interdisciplinary team.
• Collaborate 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 recovery and minimize avoidable hospital readmissions.
• Uphold state and federal standards and safeguard resident rights and dignity.

Benefits

• Paid time off, accruing from the first day of orientation.
• Paid holidays.
• Access to up to 50% of earned pay daily.
• Flexible scheduling.
• Company-paid life insurance for full-time staff.
• Priority Health medical insurance, Delta Dental, and vision insurance.
• 401(k) retirement plan.
• Career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed