Director of Case Management

Director of Case Management (LPN/RN) Skilled Nursing & Post-Acute Care | Full-Time Champion Care is seeking an experienced and highly organized Director of Case Management to oversee clinical case management operations across our skilled nursing and post-acute care facilities. This leadership role is ideal for an experienced LPN or RN with strong MDS, Medicare, managed care, and reimbursement knowledge who understands the critical connection between clinical documentation, payer management, length of stay, and financial performance. The Director of Case Management will partner closely with facility leadership, MDS teams, admissions, therapy, and business office personnel to optimize reimbursement, improve authorization outcomes, support census growth, and ensure exceptional resident care throughout the post-acute stay. If you have a background as an MDS Coordinator, Regional MDS Nurse, Case Manager, Clinical Reimbursement Specialist, Managed Care Coordinator, or Director of Case Management , we encourage you to apply. Key Responsibilities Lead and oversee case management operations across multiple skilled nursing facilities. Provide guidance and support to facility MDS Coordinators and clinical teams regarding reimbursement and payer requirements. Monitor and manage insurance authorizations, concurrent reviews, updates, extensions, and appeals. Review MDS processes and documentation to support accurate reimbursement and regulatory compliance. Collaborate with admissions teams to evaluate referrals and optimize payer opportunities. Monitor Medicare, Medicaid, Managed Care, and commercial insurance utilization. Analyze length of stay trends, denial patterns, and reimbursement opportunities. Partner with therapy, nursing, and interdisciplinary teams to ensure appropriate clinical documentation. Support discharge planning efforts and transitions of care. Assist facilities with complex payer issues, authorization challenges, and reimbursement concerns. Conduct audits and provide education related to case management, reimbursement, and managed care processes. Track key performance indicators and develop action plans to improve outcomes. Participate in weekly reimbursement, Medicare, and managed care review meetings. Ensure compliance with federal, state, and payer-specific regulations. Assist with training, onboarding, and development of facility-based case management and MDS staff. Qualifications Current LPN or RN license required. MDS experience in a skilled nursing facility setting required. Previous experience as an MDS Coordinator, Case Manager, Clinical Reimbursement Specialist, or similar role preferred. Strong understanding of Medicare, Medicaid, PDPM, Managed Care, and post-acute reimbursement processes. Skilled nursing facility experience required. Ability to analyze clinical and financial data to identify reimbursement opportunities. Strong leadership, communication, and organizational skills. Ability to manage multiple priorities and support multiple facilities. Experience working collaboratively with admissions, therapy, nursing, and business office teams. Why Join Champion Care Competitive salary based on experience. Paid time off Company-paid health, dental, and vision insurance. Industry-leading bonus program. Opportunity to support and influence multiple facilities across a growing healthcare organization. Collaborative leadership team and strong operational support. Significant opportunities for professional growth and advancement. Champion Care is an Equal Opportunity Employer (EOE). We are committed to creating an inclusive workplace for all employees and applicants and do not discriminate based on race, color, religion, sex, national origin, age, disability, genetic information, or any other protected status. #J-18808-Ljbffr