Director of Facility Based Clinical Reimbursement
Listed on 2026-08-05
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Nursing
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 ResponsibilitiesProvide 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.
At Hillcrest, we believe in providing a career that helps you thrive—both professionally and personally. We offer:
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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