Regional Director, Clinical Reimbursement-EXEMPT
What makes National Health Care Associates (NHCA) a GREAT fit for you?
When you join NHCA, you become part of a premier provider of short-term rehabilitation, skilled nursing, and post-hospital care. Our care team of more than 7,000 employees in six states cares for patients throughout the Northeast. We built a comprehensive network of services for each of our 40+ centers, carefully designed to address the individual needs of every person entrusted to our care.
Our mission is to provide our residents and their families with superior care delivered by staff dedicated to the principles of kindness, compassion, service, and excellence in an environment where individuality, dignity, and value of those who are served, as well as those who serve, is nurtured and appreciated. We believe that life, at all stages and with all of its challenges, is a precious gift to be shared and celebrated. It is our privilege to participate in the lives of our residents, their friends and families by offering them not only physical but emotional care, comfort, and support.
At National Health Care Associates…We Touch People’s Lives.
Who You Are:
- Kind, Compassionate, Service Minded, & Excellence Driven
What You Will Do:
- Promote the capturing of appropriate clinical reimbursement for services provided, while ensuring highest level of revenue integrity with support of corporate established reimbursement initiatives
- Optimize reimbursement and identify opportunity through tracking, trending, and analyzing relevant data with supervisor guidance
- Strategic planning as relates to case-mix systems
- Perform auditing activities as outlined by the Director of Clinical Reimbursement
- Perform consistent, focused data mining throughout assigned region
- Provide facility visits as required with timely report of findings
- Respond promptly to facility and regional team inquiries related to MDS and reimbursement
- Provide management level presentation materials during quarterly meetings as outlined
- Participate in the hiring of MDS coordinators.
- Assist with orientation and education for MDS coordinators and other IDT members as relates to MDS and/or reimbursement processes
- Provide ongoing education and communication with the facility Administrators, MDS staff, and clinical staff as relates to current state and federal regulation governing billing and reimbursement in respective region.
- Other related duties as assigned
What You Will Need:
- Registered nurse with 3+ years MDS reimbursement experience
- Computer literacy (Word, Excel, Power Point, Outlook). Experience with current EMR software a plus
- Evidence of effective written, verbal and technological communication
- Demonstrates excellent organization, communication and presentation skills
- Deadline driven, detail-oriented individual with strong analytical capabilities
- Working knowledge of state and federal regulations governing the MDS and billing processes within a nursing facility
- Ability to communicate with and elicit support from other regionals and IDT members at the facility level
- Ability to apply knowledge in state specific Medicaid and Medicare RUG/PDPM methodologies
- Ability to successfully train new MDS coordinators and IDT members with varying levels of experience as appropriate
- Ability to conduct themselves with a fair, honest, consistent, and professional temperament
- Ability to travel >50%, with possible overnight and out of state travel assignments
- Exhibits independent and self-directed work ethic with the ability to manage multiple facilities data
Diversity, Inclusion, & Engagement at National Health Care Associates:
At National Health Care Associates, we not only accept difference, we promote it, we embrace it, and we thrive on it for the betterment of our patients, our employees, and our culture.
We are proud to be an equal opportunity workplace and an affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status or any other status protected under applicable law.
Job Type: Full-time
Schedule:
- 8 hour shift
- Monday to Friday
Education:
Experience:
- Nursing: 1 year (Preferred)
- Supervising Experience: 1 year (Preferred)
License/Certification:
Work Location:
Work Remotely: