Chief Clinical Reimbursement Officer (MDS)

Eden Senior Care, LLC; Skokie (IL); On-site; USD 150,000 - 210,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Paid Time Off

401(k) with company match

Tuition Reimbursement

Phone allowance

Company laptop/equipment

Professional development

Job summary

Eden Senior Care, LLC is seeking a Chief Clinical Reimbursement Officer to provide high-level leadership for MDS and reimbursement operations across 26 Skilled Nursing Facilities in Wisconsin, Minnesota, Illinois, and Pennsylvania.

The role oversees four Regional MDS Coordinators, conducts executive-level training, and drives PDPM accuracy and financial performance. Travel up to 25% is expected, with crossover support across regional teams.

Qualifications

• Active RN license required.
• Minimum of 3 years' experience as an MDS Coordinator with multi-site or regional leadership, preferred.
• RAC-CT or advanced reimbursement certification preferred.
• Deep expertise in reimbursement systems, PDPM, CMI and quality reporting.

Responsibilities

• Lead reimbursement strategy and compliance across multiple facilities.
• Ensure resident needs are met, documentation standards upheld, and outcomes achieved.
• Deliver executive-level training and in-services to clinical teams.
• Serve as a resource for clinical programs, caseload development, education and training.
• Drive operational, clinical and financial success across supported facilities.
• Mentor and guide Regional MDS Coordinators, fostering accountability and excellence.
• Lead Utilization Review processes, validating PDPM scores and reimbursement accuracy.
• Partner with interdisciplinary teams to ensure compliance with survey readiness, PDPM, CMI, managed care reimbursement, value-based purchasing and quality reporting programs.
• Maintain ongoing communication with facility leadership, providing coverage and support as needed.

Skills

Leadership

Strategic planning

Healthcare reimbursement

Communication

Travel readiness

Education

RN license

Tools

PDPM

CMI

Reimbursement systems

Job description

Eden Senior Care, founded in 2016, is a growing Healthcare Management company, focused on managing and operating Skilled Nursing communities in Minnesota, Wisconsin, Illinois and Pennsylvania. Our mission with each community is to support their success by providing strong leadership, corporate support, and the resources and tools to realize their goals. Eden Senior Care promotes and encourages the success of each of its employees and values the individual experience of its guests and their families.

Position

Chief Clinical Reimbursement Officer

Location

Preferred candidates will be based in Wisconsin, Minnesota, Illinois, or Pennsylvania. However, we remain open to strong applicants from other regions. This role oversees a team of four Regional MDS Coordinators who handle most onsite travel. While the Chief Clinical Reimbursement Officer will occasionally travel for team training and strategic oversight, overall travel is expected to be less than 25%, with flexibility as needed.

Scope of Role

The Chief Clinical Reimbursement Officer will provide high-level leadership and strategic direction for MDS and reimbursement operations across 26 Skilled Nursing Facilities in Wisconsin, Minnesota, Illinois, and Pennsylvania.

Key Responsibilities

• Lead reimbursement strategy and compliance across multiple facilities.
• Ensure resident needs are met, documentation standards are upheld, and outcomes achieved efficiently.
• Deliver executive-level training and in-services to clinical teams.
• Serve as a resource for clinical programs, caseload development, education, and training.
• Drive operational, clinical, and financial success across supported facilities.
• Mentor and guide Regional MDS Coordinators, fostering accountability and excellence.
• Lead Utilization Review processes, validating PDPM scores and reimbursement accuracy.
• Partner with interdisciplinary teams to ensure compliance with survey readiness, PDPM, CMI, managed care reimbursement, value-based purchasing, and quality reporting programs.
• Maintain ongoing communication with facility leadership, providing coverage and support as needed.

Qualifications

• Active RN license required. A multistate compact license covering Wisconsin, Minnesota, Illinois, or Pennsylvania is strongly preferred, with Minnesota licensure considered an additional advantage.
• Minimum of 3 years' experience as an MDS Coordinator, with multi-site or regional leadership strongly preferred and the proven ability to support operations at the regional level.
• RAC-CT or advanced reimbursement certification preferred.
• Deep expertise in reimbursement systems, survey processes, PDPM, CMI, managed care, and quality reporting.
• Proven ability to lead interdisciplinary teams and drive organizational performance.
• Strong organizational and problem-solving skills; resourceful in setting priorities and guiding investment in people and systems.
• Excellent communication and leadership skills, with integrity, credibility, and commitment to mission.
• Ability to travel up to 25% as needed.

Benefits

• Health, dental, and vision insurance
• Vacation, holiday, and sick PTO
• 401(k) with company match
• Tuition reimbursement
• Phone allowance and company-provided laptop/equipment
• Professional development support, including eligibility to attend the AAPACN Conference annually
• Collaborative and supportive work culture