Director of Clinical Reimbursement

Cura Health; Minnesota; On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health plan

Paid time off

HSA eligibility

Retirement plan 4% match

Life insurance

Training & development

Job summary

Cura Health seeks an experienced MDS Coordinator to lead the MDS/RAI process within our nursing leadership team. You will ensure accurate assessments, care planning, and compliant documentation that supports appropriate reimbursement.

You will collaborate with nursing, therapy, social services, dietary, and other teams to reflect residents’ needs and services across assessments and plans. A Minnesota RN license and prior MDS experience are highly valued.

Qualifications

• Current and active RN license in Minnesota.
• Experience in a skilled nursing or long-term care setting preferred.
• Previous MDS experience strongly preferred.
• Knowledge of MDS 3.0 and RAI process preferred.
• Understanding of Medicare, Medicaid, PDPM, and skilled nursing reimbursement preferred.
• Strong clinical assessment and critical-thinking skills.
• Excellent attention to detail and ability to maintain accurate documentation.
• Strong organizational and time-management skills with the ability to manage multiple deadlines.
• Ability to interpret clinical documentation and communicate effectively with the interdisciplinary team.

Responsibilities

• Oversee and coordinate the resident assessment process.
• Coordinate and complete MDS assessments per federal and state requirements and timelines.
• Manage the RAI process and maintain an accurate MDS assessment schedule.
• Ensure assessments are accurate, thorough, and submitted on time.
• Collaborate with the interdisciplinary team to gather information for assessments and care planning.
• Coordinate and participate in comprehensive resident care planning.
• Review clinical documentation to reflect resident conditions, services, and functions.
• Identify documentation gaps and work with nursing and other departments to improve accuracy.
• Monitor Medicare and skilled nursing documentation to support medical necessity and reimbursement.
• Maintain knowledge of current MDS, RAI, Medicare, Medicaid, PDPM, and CMS requirements.
• Review resident information for appropriate coding and reimbursement classifications.
• Track assessment reference dates, completion dates, submissions, and other MDS deadlines.
• Complete required modifications and assessments when necessary.
• Monitor changes in resident condition to determine if additional assessments are needed.
• Work with therapy and nursing to capture services and resident needs accurately.
• Participate in interdisciplinary meetings, quality improvement initiatives, and clinical meetings as needed.
• Assist with audits, surveys, and documentation reviews.
• Educate staff on documentation requirements and MDS-related processes.
• Maintain resident confidentiality and HIPAA compliance.
• Support facility quality measures, resident outcomes, and reimbursement accuracy.

Skills

RN license

Nursing experience

MDS knowledge

RAI process

Medicare/Medicaid knowledge

PDPM knowledge

Documentation accuracy

Interdisciplinary collaboration

Time management

Regulatory compliance

Tools

Electronic Health Records (EHR)

Job description

At Cura of Le Sueur, we are looking for an experienced, organized, and detail-oriented MDS Coordinator to join our nursing leadership team. The Director of Clinical Reimbursement plays an important role in ensuring accurate resident assessments, individualized care planning, regulatory compliance, and appropriate reimbursement within our skilled nursing facility.

In this role, you will coordinate the completion of the Minimum Data Set (MDS) and Resident Assessment Instrument (RAI) process while working closely with nursing, therapy, social services, dietary, activities, providers, and other members of the interdisciplinary team. You will help ensure that each resident’s clinical needs, functional abilities, and services are accurately reflected throughout the assessment and care planning process.

The ideal candidate has strong clinical judgment, excellent attention to detail, and an understanding of MDS, Medicare, Medicaid, and skilled nursing reimbursement. This position is a great opportunity for a nurse who enjoys combining clinical knowledge with assessment, documentation, compliance, and interdisciplinary collaboration.

At Cura of Le Sueur, we believe strong clinical leadership directly contributes to better resident outcomes. If you are looking for an opportunity to use your nursing experience in a role that impacts both quality of care and facility operations, we would love to have you join our team.

What You’ll Do

As the Director of Clinical Reimbursement you will oversee and coordinate the resident assessment process while helping ensure assessments, documentation, and care plans accurately represent the needs of each resident.

• Coordinate and complete MDS assessments in accordance with federal and state requirements and established timelines.
• Manage the Resident Assessment Instrument (RAI) process and maintain an accurate MDS assessment schedule.
• Ensure assessments are completed accurately, thoroughly, and submitted within required timeframes.
• Collaborate with the interdisciplinary team to gather information needed for resident assessments and care planning.
• Coordinate and participate in comprehensive resident care planning.
• Review clinical documentation to ensure resident conditions, services, treatments, and functional abilities are accurately reflected.
• Identify documentation gaps and work with nursing and other departments to improve documentation accuracy and consistency.
• Monitor Medicare and skilled nursing documentation to support medical necessity and appropriate reimbursement.
• Maintain knowledge of current MDS, RAI, Medicare, Medicaid, PDPM, and CMS requirements.
• Review resident information for appropriate coding and reimbursement classifications.
• Track assessment reference dates, completion dates, submissions, and other required MDS deadlines.
• Complete required modifications, corrections, and assessments when necessary.
• Monitor changes in resident condition and determine when additional assessments or care plan updates may be required.
• Work closely with therapy and nursing to ensure services and resident needs are accurately captured.
• Participate in interdisciplinary meetings, quality improvement initiatives, and other clinical meetings as needed.
• Assist with audits, surveys, documentation reviews, and requests for supporting clinical information.
• Educate nursing staff and other team members regarding documentation requirements and MDS-related processes.
• Maintain resident confidentiality and ensure compliance with HIPAA and facility policies.
• Support facility efforts related to quality measures, resident outcomes, regulatory compliance, and reimbursement accuracy.
• Perform additional duties related to MDS, care planning, and clinical operations as assigned.
  Why Cura of Le Sueur?

At Cura of Le Sueur, we recognize that the Director of Clinical Reimbursement is an important connection between resident care, clinical documentation, quality outcomes, and reimbursement. We are looking for someone who wants to be an active part of our clinical leadership team and contribute to the continued success of our facility.

• Current and active Registered Nurse (RN) license in the state of Minnesota.

• Previous nursing experience in a skilled nursing or long-term care setting preferred.

• Previous MDS experience strongly preferred.

• Knowledge of the MDS 3.0 and Resident Assessment Instrument (RAI) process preferred.

• Understanding of Medicare, Medicaid, PDPM, and skilled nursing reimbursement preferred.

• Strong clinical assessment and critical-thinking skills.

• Excellent attention to detail and ability to maintain accurate documentation.

• Strong organizational and time-management skills with the ability to manage multiple deadlines.

• Ability to interpret clinical documentation and communicate effectively with members of the interdisciplinary team.

• Strong written and verbal communication skills.

• Comfortable working with electronic health records and other healthcare documentation systems.

• Ability to maintain confidentiality and handle sensitive resident information appropriately.

• Must meet all applicable background check, health, and employment requirements.

• Health Care Plan (Medical, Dental & Vision)

• Paid Time Off (Vacation, Sick & Public Holidays)

• Health Savings Account (HSA) eligibility

• Retirement Plan with 4% match

• Life Insurance (Basic, Voluntary & AD&D)

• Training & Development