Job Title: Remote RN Admissions Coordinator – Long-Term Care & Rehabilitation
Company: Leading Managed Care Organization (serving Ohio Medicaid members)
Location: Remote – Must reside and be licensed in Ohio
Job Type: Full-Time
Department: Care Management / Utilization Management
Salary: $85,000
Position Summary
A managed care organization serving Ohio Medicaid members is seeking an experienced and compassionate Registered Nurse (RN) to join its Care Management team in a fully remote capacity. This position is responsible for coordinating and facilitating admissions to long-term care and rehabilitation facilities for members requiring skilled or extended care services. The ideal candidate will have a background in home health, senior living intake, or long-term care admissions, along with a strong understanding of Medicaid eligibility, coverage, and placement protocols.
Key Responsibilities
Coordinate and oversee admissions and transitions of care for members entering long-term care, skilled nursing facilities (SNFs), or subacute rehabilitation settings.
Independently review clinical documentation and assessments to determine appropriate placement based on member needs and Ohio Medicaid guidelines.
Serve as the primary liaison between the health plan, facility admissions teams, discharge planners, and providers to ensure smooth and timely placements.
Manage prior authorization processes, approve services within scope, and confirm Medicaid eligibility.
Collaborate with Utilization Management and Case Management teams to support continuity of care and efficient resource utilization.
Provide education to members and families regarding benefits, services, and expectations during care transitions.
Maintain accurate, detailed documentation in EMR and care management systems.
Ensure compliance with all state regulations, HIPAA requirements, and internal quality standards.
Qualifications
Active, unrestricted RN license in the State of Ohio (required).
Minimum of 3 years of clinical experience in home health, long-term care, rehabilitation, or admissions/intake coordination.
Strong knowledge of Ohio Medicaid systems, authorizations, and coverage criteria.
Excellent communication, critical thinking, and documentation skills.
Proficiency with electronic medical records (EMR) and care coordination software.
Ability to work independently and remotely in a fast-paced environment.
Preferred Experience
Managed care, health plan, or insurance case management background.
Experience in discharge planning, transitional care, or post-acute navigation.
Bilingual English/Spanish is a plus but not required.
Benefits Include
Competitive compensation, full benefits package, 401(k) with match, generous paid time off, continuing education support, and remote work flexibility.