More jobs:
Director of Facility Clinical Reimbursement
Job in
Bellevue, Sarpy County, Nebraska, 68123, USA
Listed on 2026-01-12
Listing for:
Hillcrest Health & Living
Full Time
position Listed on 2026-01-12
Job specializations:
-
Healthcare
Healthcare Management, Healthcare Administration
Job Description & How to Apply Below
Director of Facility-Based Clinical Reimbursement
Hillcrest Health & Living is seeking an experienced and strategic Director of Facility-Based Clinical Reimbursement (RN) to lead and oversee all reimbursement-related functions across our post-acute and long-term care communities. This individual will serve as a key resource for ensuring compliance, accuracy, and optimization of the MDS and PDPM processes, while supporting our mission of Inspiring people to live their best lives.
Key Responsibilities- Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.
- Ensure accurate, timely completion and submission of MDS assessments in accordance with federal and state regulations.
- Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.
- Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer‑specific reimbursement systems.
- Develop and implement policies and procedures to ensure consistent documentation and coding practices.
- Partner with clinical and financial leaders to align care documentation with reimbursement compliance.
- Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.
- Support education, training, and competency development for facility reimbursement teams.
- Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.
- Represent the reimbursement department in interdisciplinary and corporate‑level meetings.
- Current Registered Nurse (RN) license in the state of Nebraska (or compact state).
- Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.
- Prior experience in post‑acute care, long‑term care, or skilled nursing facility management required.
- Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and clinical documentation requirements.
- Proven ability to lead, educate, and mentor multi‑site clinical reimbursement teams.
- Excellent analytical, organizational, and communication skills.
- Ability to travel periodically between facilities.
- Comprehensive health, dental, and vision insurance options
- Paid time off
- Tuition reimbursement and student loan repayment for nurses
- Career growth and development opportunities
- A mission‑driven culture centered on Integrity, Compassion, Respect, Teamwork, and Service
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