Company Overview
[$COMPANY_OVERVIEW]
Role Overview
We are seeking an experienced and strategic Director of MDS/Clinical Reimbursement to lead and enhance our clinical reimbursement strategies across the organization. In this pivotal role, you will leverage your comprehensive understanding of Medicare and Medicaid reimbursement policies to optimize revenue cycles and ensure compliance with regulatory standards. Your leadership will drive innovation in our reimbursement processes, fostering collaboration across cross-functional teams to enhance patient care outcomes and operational efficiencies.
Responsibilities
- Develop and execute comprehensive strategies for MDS (Minimum Data Set) assessments and clinical reimbursement processes, ensuring alignment with federal and state regulations.
- Oversee the analysis of clinical data to identify trends and opportunities for improvement in reimbursement rates and practices.
- Collaborate with clinical teams to ensure accurate documentation and coding practices that reflect the level of care provided.
- Lead education and training initiatives for clinical and administrative staff on reimbursement policies, coding updates, and compliance requirements.
- Engage in ongoing monitoring and evaluation of reimbursement performance metrics, implementing corrective actions as necessary.
- Serve as the primary liaison with government agencies and external stakeholders regarding reimbursement issues and inquiries.
Required and Preferred Qualifications
Required:
- Master's degree in Healthcare Administration, Nursing, or a related field.
- 7+ years of experience in clinical reimbursement, MDS management, or healthcare finance, with a proven track record of successful program development.
- In-depth knowledge of Medicare and Medicaid reimbursement policies, as well as familiarity with regulatory compliance requirements.
- Strong analytical skills and the ability to interpret complex data sets to inform decision-making.
Preferred:
- Experience in long-term care or skilled nursing facility operations.
- Certification in MDS or related reimbursement certifications (e.g., RAC-CT).
- Proven track record of leading cross-functional teams and driving organizational change.
Technical Skills and Relevant Technologies
- Proficiency in healthcare data management systems and electronic health record (EHR) platforms.
- Familiarity with analytics tools for financial modeling and forecasting.
- Advanced skills in Microsoft Excel and data visualization software.
Soft Skills and Cultural Fit
- Exceptional leadership and interpersonal skills, with the ability to influence and inspire diverse teams.
- Strong problem-solving abilities, with a focus on strategic thinking and continuous improvement.
- Excellent written and verbal communication skills, with a talent for simplifying complex information.
- A proactive approach to change management and a passion for enhancing patient care through effective reimbursement practices.
Benefits and Perks
Annual salary range: [$SALARY_RANGE]
Full-time employees can expect a comprehensive benefits package, which includes:
- Health, dental, and vision insurance
- 401(k) retirement plan with company match
- Generous paid time off and holidays
- Flexible work arrangements
- Professional development opportunities and tuition reimbursement
Equal Opportunity Statement
[$COMPANY_NAME] is committed to fostering a diverse and inclusive workplace. We are an Equal Opportunity Employer and welcome applications from all qualified individuals regardless of race, color, religion, gender, sexual orientation, national origin, age, disability, or any other status protected by applicable law.
Location
This is a remote position within [$COMPANY_LOCATION].
We strongly encourage applicants from diverse backgrounds to apply, even if you do not meet all the qualifications listed. Your unique perspectives and experiences are valuable to us.