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Director of Facility Clinical Reimbursement

Job in Bellevue, Sarpy County, Nebraska, 68123, USA
Listing for: Hillcrest Health & Living
Full Time position
Listed on 2026-01-12
Job specializations:
  • Healthcare
    Healthcare Management, Healthcare Administration
Salary/Wage Range or Industry Benchmark: 100000 - 125000 USD Yearly USD 100000.00 125000.00 YEAR
Job Description & How to Apply Below
Position: Director of Facility Based Clinical Reimbursement

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.
Qualifications
  • 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.
Why Hillcrest
  • 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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