Medication management is increasingly challenging in residential aged care (RAC). Residents have complex care needs, and medication use is often a balance between managing multiple conditions while ensuring the best quality of life. The National Aged Care Medication Roundtable is a collaborative project that brings together aged care providers, policy experts, consumer advocates and researchers, providing a forum to review data and discuss strategies to improve medication management in RAC. One aim of the Roundtable is to co-design and implement interventions to improve appropriate medication use in RAC. We conducted a scoping study where RAC staff and pharmacists were interviewed to understand priorities for medication management and identify potential interventions to address these priorities. The Australian National Medication Management in Residential Aged Care Facilities Guiding Principles, and the WHO Framework for Countries to Achieve an Integrated Continuum of Long-Term Care were adapted to guide a needs assessment. Focus areas related to Governance, Service delivery, Information, monitoring and evaluation systems, Partnership and engagement, Person-centered care and shared-decision making, and Quality improvement. Findings were consolidated with quarterly Roundtable discussions held over a 3-year period. Stakeholders preferred an “intervention bundle” based on a nudge approach, targeting the overuse of antibiotics consisting of three components: 1) audit and feedback, 2) a statement of public commitment, and 3) consumer resources. In this study, we describe stakeholder priorities, barriers, and facilitators to medication management in RAC, and initial preferences for the intervention bundle that will be co-designed and tested at facilities in a randomised controlled trial.