Regional Director of Clinical Reimbursement (RN Preferred)
- Ensure compliance with state and federal regulations (RAI, PDPM, CMS, etc.)
- Manage accurate and timely MDS submissions and data integrity
- Support billing accuracy and optimize reimbursement outcomes
- Conduct audits and develop corrective action plans as needed
- Deliver staff training on MDS, clinical documentation, and quality measures
- Analyze trends in quality measures and reimbursement performance
- Serve as a liaison between clinical, administrative, and billing teams
- Provide hands-on support during staffing gaps to maintain operational continuity
- Prepare and deliver reports on regional performance
- Active nursing license required (RN preferred; multi-state license preferred)
- Minimum 3 years of experience in MDS and clinical reimbursement (regional experience a plus)
- Strong knowledge of PDPM, RAI guidelines, CMS quality measures, and reimbursement practices
- Ability to train and mentor facility staff
- Strong organizational and communication skills
- Willingness and ability to travel within the assigned region regularly
- Proficient with EMR/MDS systems and Microsoft Office
- Remote work with field-based travel
- Must be able to respond to urgent needs at facilities in a timely manner
- Occasional evening or weekend support may be required during audits or coverage situations
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