About this opportunity
Nightingale lists this Director of Managed Care opportunity in workfromhome, Ohio. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Director of Managed Care
Remote Position
RN/LPN Preferred
Job Summary:
We are seeking an experienced, detail-driven Director of Managed Care to oversee prior authorizations, payer coordination, and utilization management across six skilled nursing facilities in Arkansas and Ohio . As a key member of our team, you will ensure timely authorizations, accurate documentation, and strong communication with payers to optimize reimbursement and resident care.
Responsibilities:
Manage and process all prior authorizations for admissions, continued stays, therapy services, and specialty care
Serve as the primary contact for managed care organizations, insurance plans, and payer representatives
Monitor authorization timelines , length of stay, and payer requirements to ensure compliance
Collaborate daily with MDS, nursing leadership, therapy, admissions, and regional leadership
Track, resolve, and appeal denials , ensuring complete and accurate documentation
Provide clear, consistent communication to facility teams regarding authorization status and next steps
Identify trends, barriers, and opportunities to strengthen managed care outcomes
Maintain organized workflows and reporting across all six facilities
Requirements:
Strong background in Managed Care , Utilization Review, Prior Authorization, or MDS within SNF/LTC
Deep understanding of Medicare Advantage , commercial plans, and authorization processes
Excellent communication, follow-through, and problem-solving skills
Ability to manage multiple facilities, deadlines, and payer relationships
Highly organized, tech-savvy, and comfortable working fully remote
Proactive, positive, team-focused professional who thrives in a collaborative environment
Your expertise ensures residents receive timely approvals, facilities maintain accurate reimbursement, and teams across Arkansas and Ohio stay aligned and supported. You'll be the central hub that keeps managed care operations running smoothly.
Why Join Us:
Fully remote role
Supportive, mission-driven leadership
Opportunity to impact outcomes across multiple communities
Competitive compensation
A role where your work directly strengthens resident care and operational success
If you're passionate about managed care excellence and excited to support six dedicated healthcare teams across Arkansas and Ohio, we want to meet you.
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.