Full Spectrum Search Group
Director of Clinical Reimbursement Skilled Nursing
Full Spectrum Search Group, Westerville, Ohio, United States, 43082
Director of Clinical Reimbursement - Skilled NursingFull Spectrum Search Group is a full-service healthcare recruiting agency specializing in long-term care leadership and healthcare administration. At Full Spectrum, our team of healthcare recruiters is dedicated to bringing exceptional operators and candidates together.We are seeking an experienced
Director of Clinical Reimbursement
in
Westerville, OH .
Needs to be RN.This is a position with a trusted skilled nursing operator. Our client places employees at the forefront. You can expect a
range
salary base around $150,000.
This role is hiring immediately.PerksCompetitive health benefits401k match up to 4%Lucrative bonus planQualificationsActive RN (Registered Nurse) license in state of residence or state(s) of practice, bachelor’s degree in nursing (BSN) is preferred.NAC CertificationMust have, as a minimum, 5+ years’ experience with RAI process and PPS at the regional level or above and regulations knowledge.Multi-facility experience preferred with Ohio, NC, VA and IN state specific experience.Demonstrate and understand value-based payment and case mix reimbursement methodology.Ability to travel up to 50%ResponsibilitiesAssist with development of systems/processes in collaboration with VPCO and VPO to ensure regional and facility staff can perform efficiently.Provides information and education on the importance and use of the RAI/PPS/VA processes and their correlation to resident care and reimbursement.Provides instruction on how to read, interpret and use the information contained in various state and company generated reports, such as State Missing Assessment Report, Quality Indicators/Quality Measures, State Validation, Simple LTC Reports, etc.Based on information derived from audits and other available data, the Director provides expertise, consultation, and guidance to appropriate employees to ensure MDS (Minimum Data Set) accuracy and adherence to company policy and procedures as well as state and federal regulations and guidelines.Through analysis of financial and clinical reports, identifies trends and areas of improvement and ensures an appropriate action plan is completed monthly.Maintains in-depth knowledge of the clinical billing system and the MDS process to help investigate/troubleshoot user-related software issues.Oversees and coordinates the process for a thorough and timely orientation for new MDS Coordinators.Ensures current, new, and revised RAI/PPS information is distributed to appropriate employees promptly.Participates in the Quality Review process.Schedules announced and unannounced visits to the facilities.Serves as a member of the CQAMC meeting as required.Serves as a member of the policy and procedure committee.Oversees the restorative program policies and procedures.Assist to identify changes necessary regarding current policies and procedures and established facility policies and procedures and communicates recommendations to the VPCO.To learn more about this role, connect with us quickly by texting (949) 596-7205, LiveChatting at www.fullspecstaff.com, or emailing jobs@fullspecstaff.com.Full Spectrum is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
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Director of Clinical Reimbursement
in
Westerville, OH .
Needs to be RN.This is a position with a trusted skilled nursing operator. Our client places employees at the forefront. You can expect a
range
salary base around $150,000.
This role is hiring immediately.PerksCompetitive health benefits401k match up to 4%Lucrative bonus planQualificationsActive RN (Registered Nurse) license in state of residence or state(s) of practice, bachelor’s degree in nursing (BSN) is preferred.NAC CertificationMust have, as a minimum, 5+ years’ experience with RAI process and PPS at the regional level or above and regulations knowledge.Multi-facility experience preferred with Ohio, NC, VA and IN state specific experience.Demonstrate and understand value-based payment and case mix reimbursement methodology.Ability to travel up to 50%ResponsibilitiesAssist with development of systems/processes in collaboration with VPCO and VPO to ensure regional and facility staff can perform efficiently.Provides information and education on the importance and use of the RAI/PPS/VA processes and their correlation to resident care and reimbursement.Provides instruction on how to read, interpret and use the information contained in various state and company generated reports, such as State Missing Assessment Report, Quality Indicators/Quality Measures, State Validation, Simple LTC Reports, etc.Based on information derived from audits and other available data, the Director provides expertise, consultation, and guidance to appropriate employees to ensure MDS (Minimum Data Set) accuracy and adherence to company policy and procedures as well as state and federal regulations and guidelines.Through analysis of financial and clinical reports, identifies trends and areas of improvement and ensures an appropriate action plan is completed monthly.Maintains in-depth knowledge of the clinical billing system and the MDS process to help investigate/troubleshoot user-related software issues.Oversees and coordinates the process for a thorough and timely orientation for new MDS Coordinators.Ensures current, new, and revised RAI/PPS information is distributed to appropriate employees promptly.Participates in the Quality Review process.Schedules announced and unannounced visits to the facilities.Serves as a member of the CQAMC meeting as required.Serves as a member of the policy and procedure committee.Oversees the restorative program policies and procedures.Assist to identify changes necessary regarding current policies and procedures and established facility policies and procedures and communicates recommendations to the VPCO.To learn more about this role, connect with us quickly by texting (949) 596-7205, LiveChatting at www.fullspecstaff.com, or emailing jobs@fullspecstaff.com.Full Spectrum is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
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