Are you ready to make a change?
We are seeking an experienced Regional MDS / PDPM / CMI / RAI Consultant to provide remote reimbursement, MDS, PDPM, Case Mix Index, and RAI support to our long-term care and skilled nursing facilities.
This position will provide regional oversight to ensure accurate MDS completion, proper PDPM classification, optimized reimbursement, accurate case mix, regulatory compliance, and strong interdisciplinary team processes. Quarterly travel to assigned facilities will be required for on-site audits, training, clinical reimbursement review, and team support.
This role is ideal for a highly organized MDS professional with strong knowledge of PDPM, RAI guidelines, CMI, care planning, Medicare documentation, and long-term care reimbursement systems.
Key Responsibilities
Provide regional oversight for MDS, PDPM, CMI, and RAI processes
Monitor timely and accurate MDS completion across assigned facilities
Review PDPM classifications, clinical documentation, diagnosis coding, and reimbursement accuracy
Support Case Mix Index improvement through accurate assessment and documentation
Audit MDS assessments for accuracy, compliance, and missed reimbursement opportunities
Review Medicare Part A documentation and skilled coverage support
Assist with Triple Check and Medicare meetings
Support facility MDS Coordinators, DONs, Administrators, and interdisciplinary teams
Review care plans for accuracy and alignment with MDS assessments
Monitor ARD schedules, assessment calendars, significant change assessments, and discharge assessments
Provide education and coaching to facility MDS and clinical teams
Assist with RAI Manual interpretation and regulatory compliance
Identify trends, risks, late assessments, coding errors, and reimbursement concerns
Participate in monthly or quarterly reimbursement reviews with regional leadership
Travel quarterly to assigned facilities for audits, training, and operational support
Qualifications
Active RN license required
Long-term care/skilled nursing experience required
MDS experience required
Strong knowledge of PDPM, RAI, CMI, Medicare, and Medicaid case mix processes
Experience with multi-facility MDS oversight preferred
RAC-CT certification preferred
Experience with Triple Check, Medicare meetings, care planning, and reimbursement audits preferred
Strong understanding of RAI Manual requirements
Ability to work independently from home
Strong communication, organization, auditing, and follow-through skills
Ability to travel quarterly to assigned facilities
Experience with PCC or similar electronic health record system preferred
Compensation & Benefits
Competitive salary or hourly rate
Primarily remote/work-from-home position
Quarterly travel reimbursement
Mileage reimbursement
Lodging and meal reimbursement when overnight travel is required
Licensure or certification reimbursement as approved
Opportunity to support multiple facilities and directly impact reimbursement accuracy, compliance, and clinical outcomes
Regional Reimbursement Nurse Consultant • Omaha, Nebraska
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