Vice President – Clinical Reimbursement

Job not on LinkedIn

🕒 October 22

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🔴 Lead

👔 Vice President

👻 Ghost score 15%

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📋 Description

• Oversee Clinical Reimbursement Specialists to ensure RAI guidelines are followed throughout the Eastern division • Provide guidance and oversight to Clinical Reimbursement Specialists and assessment coordinators regarding MDS and reimbursement processes • Review MDS assessments quarterly, including quarterlies, annuals, significant changes, and admissions • Review admissions and discharges to ensure discharge and re-entry assessments are present and properly dated • Review Medicare PPS assessments quarterly for accurate coding and supporting documentation • Review Medicare assessment scheduling monthly and monitor grace-day usage • Review Medicare certifications monthly for required documentation and signatures • Review facility RUG reports monthly and monitor trends • Participate in facility pre-survey processes focused on MDS and reimbursement • Review Case Mix Reports quarterly • Schedule monthly MDS Coordinator conference calls to review Case Mix projections • Assist with orientation of newly appointed MDS Coordinators • Mentor and guide assessment offices during site visits and via email and telephone • Plan and implement MDS Coordinator conferences • Develop and revise MDS-related policies and procedures and oversee implementation • Monitor Clinical Reimbursement Specialist activities through periodic visits to Eastern division facilities • Participate in corporate committees as assigned by the Chief Operating Officer • Develop a quarterly clinical reimbursement newsletter • Develop templates for facility audits and educational sessions • Perform other duties as assigned

🎯 Requirements

• Minimum of 7 years as an active Registered Nurse in the Commonwealth of Pennsylvania • Minimum of 5 years in long term care with MDS experience required • Extensive knowledge of the RAI process and reimbursement requirements for both PPS and case mix • BSN required • RAC-CT certification • Current RN license required and must be in good standing with the Commonwealth of Pennsylvania • Current Basic Life Support for Health Care Providers CPR certificate • Previous experience completing Resident Minimum Data Sets and care planning preferred • Basic computer knowledge • Ability to read, write, and follow oral and written directions • Ability to perform basic mathematics • Knowledge of customer and personal service principles • Knowledge of psychology related to resident and family concerns • Knowledge of safety and security policies, procedures, and strategies

🏖️ Benefits

• Remote work in Pennsylvania

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