Regional Director of Clinical Reimbursement

We rely on and trust our Regional Director of Clinical Reimbursement to provide extensive training, analysis, direction, action plan/resolution and consultation to the facilities, district and regional teams within his/her area of specialty. Validates compliance with federal and state regulations as well as Company policy and procedures regarding state case mix/Medicare payment systems, RAI process and operations.

Why Work For Us?

• Excellent pay with multiple incentives
• Excellent health benefits packages
• Career advancement opportunities
• Education reimbursement program of up to $7,500 per year
• Flexible scheduling available

Benefits Conditions:

• No waiting period for enrollment
• Three health plan options
• Delta Dental
• VSP Vision
• Free Basic Life Insurance
• Disability, Critical Illness, Accident Legal Coverage
• 401(k) Retirement Plan
• Employee Assistance Program

Responsibilities:

• Provides consultation, training and support related to the RAI Process. Medicare and state case mix payment system for assigned area with little supervision.
• Monitors, consults, and makes effective recommendations for changes and modifications to existing facility processes, systems, policies, and practices which will assure efficient, effective and compliant state Medicaid/Medicare payment performance and RAI process completion with minimal guidance.
• Responsible for training Registered Nurse Assessment Coordinator (RNAC) on accuracy and systems related to RUG mix, RAI process and Grouper calculation.
• Responsible for effective action plan resolution in areas of RAI process case-mix/Medicare system and action plans to necessary parties.
• Serves as a liaison between state and organization related to the state case-mix process, including electronic submission and state MDS requirements related to state payments.

Qualifications:

• RN or completion of a Bachelors Degree in a health care or related field
• Three to five years of clinical experience in a long term care setting, which includes supervisory, administrative, or consultative capacities
• Current knowledge of state case mix and Medicare payment systems
• Capable of maintaining regular attendance
• Must be able to work favorably across departments