Director of Clinical Reimbursement & Revenue Optimization

Job Description

Dallas, TX - Hybrid

12377 Merit Drive, Suite 900 Dallas TX 75201

Full-Time

We are seeking a Director of Clinical Reimbursement & Revenue Optimization to join our Retirement Services team. As a Director of Clinical Reimbursement & Revenue Optimization, you will serve as the enterprise leader responsible for advancing Buckner Retirement Services' reimbursement operating model by integrating clinical operations, reimbursement strategy, revenue integrity, audit oversight, standardized workflows, analytics, and leadership development to improve organizational performance, financial sustainability, and regulatory compliance.

Join our team and inspire happiness in the lives of others!

• Enterprise Reimbursement Operations
  • Establish and lead enterprise reimbursement standards, governance, and operational initiatives to drive consistency, best practices, and scalable reimbursement processes across all Buckner Retirement Services (BRS) skilled nursing communities.
• Revenue Integrity & Financial Performance
  • Drive revenue integrity and reimbursement optimization through denial reduction, revenue recovery, KPI monitoring, and strategic partnership with Finance.
• Enterprise Transformation
  • Lead enterprise transformation initiatives through standardization, system redesign, change management, acquisition integration, process improvement, and scalable operational solutions.
• Clinical Reimbursement Leadership
  • Provide enterprise leadership for skilled nursing reimbursement programs by developing reimbursement strategies, ensuring compliance and revenue integrity, monitoring regulatory and payer changes, and serving as the primary reimbursement resource for BRS communities.
• Reimbursement, MDS & Performance Optimization
  • Provide enterprise oversight of MDS processes, assessment scheduling, coding accuracy, submission practices, and documentation integrity to promote consistency, regulatory compliance, and reimbursement optimization across all skilled nursing operations.
  • Lead enterprise standardization of PDPM reimbursement practices, ensuring consistent interpretation and application of CMS requirements while identifying opportunities to improve reimbursement accuracy, reduce revenue leakage, and strengthen revenue integrity.
  • Monitor and analyze Case Mix Index (CMI), PDPM performance, reimbursement trends, and key financial indicators to identify opportunities for reimbursement optimization, operational improvement, and enterprise performance enhancement.
  • Evaluate utilization of PPS, IPA, OBRA, and other required assessments to ensure appropriate assessment timing, regulatory compliance, reimbursement integrity, and alignment with CMS requirements.
  • Collaborate with MDS, nursing, therapy, and interdisciplinary teams to improve Section GG documentation accuracy, functional assessment consistency, and interdisciplinary documentation practices that support reimbursement integrity, audit readiness, and clinical outcomes.
  • Partner with Clinical Operations and Quality leadership to monitor quality measures, Value-Based Purchasing (VBP), Quality Reporting Program (QRP) measures, and other reimbursement-related performance indicators, identifying opportunities to improve documentation, operational processes, financial performance, and quality outcomes.
  • Develop and implement enterprise audit, education, and performance monitoring processes to promote consistent assessment practices, documentation standards, and reimbursement performance across all communities.
  • Analyze enterprise reimbursement and MDS performance data to identify trends, benchmark community performance, and provide actionable recommendations that improve financial…