Regional Case Manager

Description:

NHS Management is looking for an experienced Regional Case Manager / MDS Consultant (RN) to join our leadership team and drive clinical excellence across multiple skilled nursing facilities in Central Alabama.

In this highly visible regional role, you’ll oversee the MDS and Medicare assessment process, ensure regulatory compliance, and partner with facility leadership and therapy teams to maximize quality outcomes, accurate reimbursement, and best-in-class resident care.

If you’re a strong clinical leader who thrives in a fast-paced, multi-facility environment and knows the ins and outs of MDS, Medicare A & B, PDPM, and long-term care operations — this is a great opportunity to make a real impact.

What You’ll Do
 

• Lead and coordinate the MDS and Medicare assessment process across assigned facilities
• Ensure accurate, timely completion and transmission of all Medicare and MDS assessments
• Conduct on-site audits of MDS documentation, medical records, therapy minutes, ADLs, and skilled services
• Observe residents and validate assessments for accuracy and regulatory compliance
• Provide case management support for high-risk Medicare Part A residents
• Train and support facility teams on Medicare coverage, documentation, utilization, and best practices
• Partner with therapy providers to optimize Medicare A & B utilization and rehab outcomes
• Assist with Medicare appeals, denials, and regulatory compliance efforts
• Present findings and recommendations to facility leadership during site visits
• Stay current on all MDS, PDPM, and Medicare regulatory updates and educate teams accordingly
• Participate in PPS meetings, Medicare/Rehab meetings, and Triple Check processes
   

What We’re Looking For

✔ Registered Nurse (RN) in good standing in assigned states

✔ Minimum 2 Years Of Long-term Care Experience

✔ At least 1 year of hands-on MDS and Medicare experience (required)

✔ Strong knowledge of nursing assessments, documentation, rehab, and restorative programs

✔ Excellent computer skills and MDS software proficiency

✔ Strong organization, communication, and leadership abilities

✔ Willingness to travel extensively (including overnight as needed)