Manager, Long Term Care Clinical Reimbursement
Listed on 2026-09-24
-
Management
Healthcare Management
Manager, Long Term Care Clinical Reimbursement
Posting Title
Manager, Long Term Care Clinical Reimbursement
#
2237586
Date Published
Friday, September 18, 2026
City
Springfield
State
Missouri
Country
United States
Job Category
Other Consulting Services
Advertised Location
US-AR-Rogers, US-MO-Branson, US-MO-Joplin, US-MO-Kansas City, US-MO-Saint Louis, US-MO-Springfield, US-OK-Tulsa
Working time
Full Time
Description & RequirementsOur Senior Living and Long-Term Care consulting practice helps skilled nursing and senior living providers strengthen MDS accuracy, reimbursement, clinical documentation, regulatory compliance, and operational performance. The Senior Clinical Reimbursement Consultant will lead and support client engagements, collaborate with internal reimbursement and billing teams, and help expand clinical consulting services across the practice.
This position combines hands-on clinical consulting with service development, client education, thought leadership, and technology-enabled improvement. The successful candidate will bring strong long-term care clinical expertise, sound project management skills, and the ability to translate complex reimbursement and regulatory requirements into practical client solutions.
What You Will Do:- Lead or support engagements focused on MDS completion and payer specific regulatory compliance for skilled nursing providers, including collaboration with internal billing teams to ensure accurate reimbursement
- Develop and present findings via well-organized work papers, written reports, and client-facing recommendations
- Guide clients through medical review and audit responses, and remediation plans for CMS and state-level requirements
- Provide education, training and thought leadership for DONS, MDS coordinators, and executives
- Lead the expansion of clinical consulting services including building new revenue streams, collaborating with firm leadership and marketing on go-to-market initiatives, and assisting with strategy development and multi-year growth planning
- Collaborate with internal teams to provide data-driven insights using clinical and operational analytics
- Support technology-enabled solutions, including EMR optimization (Point Click Care or similar systems), workflow improvements, and digital process enhancements
- Manage multiple client projects and deliverables while maintaining strong professional communication and responsiveness
- Monitor and evaluate evolving clinical compliance requirements related to MDS completion affecting all payers and quality outcomes, and lead education and thought leadership efforts for internal teams, clients, and prospects through state and national speaking engagements, written publications, videos, and webinars
- Establish and represent the firm as a national and state industry leader in clinical compliance and MDS completion, driving recognized expertise and differentiation in the marketplace
- Exceptional written, verbal and presentation skills
- Utilizes technology and digital platforms effectively to organize work, track deliverables, analyze information, and communicate with clients and team members while maintaining exceptional attention to detail and professionalism
- Active Registered Nurse (RN) license in good standing, with the ability to maintain licensure throughout employment
- 5+ years of clinical experience in long-term care or senior living
- Advanced knowledge in one or more of the following areas: MDS 3.0, RAI requirements, PDPM, Medicare skilled coverage, Medicaid case-mix methodologies, and supporting clinical documentation
- Ability to analyze clinical, reimbursement, and quality data using Excel and EMR reporting tools
- Experience developing standardized work papers, reports, training materials, and…
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