You've got 2 adjustment points for height, the hitch in the bed of your truck and the pin box on the 5th wheel. It takes a little trial and error but between the two you should be able to maintain bed rail clearance while keeping your 5th wheel pretty close to level.
Thanks, mbirch, that's probably what ill wind up doing. I've watched a few YouTube videos on it, and I believe I can do it. We looked at a 2005 Jayco Designer yesterday that we really liked. We were in the car, so I'm going back today and hitch to it to see what's what.
Thanks for the replies. How hard is it to flip axles, if that is necessary?