Manager, Long Term Care Clinical Reimbursement

Forvis Mazars US; Branson (MO); On-site; USD 90,000 - 120,000; Full time

Job summary

Forvis Mazars LLP seeks a Senior Clinical Reimbursement Consultant to lead MDS completion efforts and payer regulatory compliance for skilled nursing and senior living clients. You will collaborate with internal teams, develop client-ready recommendations, and provide education to DONS and MDS coordinators.

You will drive service development, contribute to multi-year growth planning, and communicate complex regulatory requirements in practical terms, leveraging technology-enabled improvements.

Qualifications

• Active RN license in good standing and maintainable during employment.
• 5+ years of clinical experience in long-term care or senior living.
• Advanced knowledge of MDS 3.0, RAI, PDPM, Medicare/Medicaid concepts.
• Ability to analyze clinical, reimbursement, and quality data using Excel and EMR tools.
• Experience creating standard workpapers, reports, and training materials.

Responsibilities

• Lead or support engagements on MDS completion and payer regulatory compliance.
• Develop findings in organized work papers, reports, and client-facing recommendations.
• Guide clients through medical reviews and CMS/state remediation plans.
• Provide education and thought leadership for DONS, MDS coordinators, and executives.
• Expand clinical consulting services, build revenue streams, and assist strategy.
• Collaborate with internal teams to deliver data-driven clinical insights.

Skills

RN license

Clinical experience

MDS 3.0 / RAI / PDPM knowledge

Excel & EMR data analysis

Training & education

Travel willingness

Microsoft Office

EMR navigation

Education

RN license

Licensed Nursing Home Administrator

Bachelor's degree in nursing / healthcare admin

Tools

PointClickCare

MatrixCare

Job description

Description & Requirements

Our Senior Living and Long-Term Care consulting practice helps skilled nursing and senior living providers strengthen MDS accuracy, reimbursement, clinical documentation, regulatory compliance, and operational performance. The Senior Clinical Reimbursement Consultant will lead and support client engagements, collaborate with internal reimbursement and billing teams, and help expand clinical consulting services across the practice.

Description & Requirements

Our Senior Living and Long-Term Care consulting practice helps skilled nursing and senior living providers strengthen MDS accuracy, reimbursement, clinical documentation, regulatory compliance, and operational performance. The Senior Clinical Reimbursement Consultant will lead and support client engagements, collaborate with internal reimbursement and billing teams, and help expand clinical consulting services across the practice. This position combines hands-on clinical consulting with service development, client education, thought leadership, and technology-enabled improvement. The successful candidate will bring strong long-term care clinical expertise, sound project management skills, and the ability to translate complex reimbursement and regulatory requirements into practical client solutions.

What You Will Do

• Lead or support engagements focused on MDS completion and payer specific regulatory compliance for skilled nursing providers, including collaboration with internal billing teams to ensure accurate reimbursement
• Develop and present findings via well-organized work papers, written reports, and client-facing recommendations
• Guide clients through medical review and audit responses, and remediation plans for CMS and state-level requirements
• Provide education, training and thought leadership for DONS, MDS coordinators, and executives
• Lead the expansion of clinical consulting services including building new revenue streams, collaborating with firm leadership and marketing on go-to-market initiatives, and assisting with strategy development and multi-year growth planning
• Collaborate with internal teams to provide data-driven insights using clinical and operational analytics
• Support technology-enabled solutions, including EMR optimization (PointClickCare or similar systems), workflow improvements, and digital process enhancements
• Manage multiple client projects and deliverables while maintaining strong professional communication and responsiveness
• Monitor and evaluate evolving clinical compliance requirements related to MDS completion affecting all payers and quality outcomes, and lead education and thought leadership efforts for internal teams, clients, and prospects through state and national speaking engagements, written publications, videos, and webinars
• Establish and represent the firm as a national and state industry leader in clinical compliance and MDS completion, driving recognized expertise and differentiation in the marketplace
• Exceptional written, verbal and presentation skills
• Utilizes technology and digital platforms effectively to organize work, track deliverables, analyze information, and communicate with clients and team members while maintaining exceptional attention to detail and professionalism

Minimum Qualifications

• Active Registered Nurse (RN) license in good standing, with the ability to maintain licensure throughout employment
• 5+ years of clinical experience in long-term care or senior living
• Advanced knowledge in one or more of the following areas: MDS 3.0, RAI requirements, PDPM, Medicare skilled coverage, Medicaid case-mix methodologies, and supporting clinical documentation
• Ability to analyze clinical, reimbursement, and quality data using Excel and EMR reporting tools
• Experience developing standardized workpapers, reports, training materials, and presentations
• Comfort evaluating new technology and AI-enabled clinical tools while maintaining appropriate privacy and compliance controls
• Ability and willingness to travel for client engagements, training, and industry presentations
• Proficient in Microsoft Office Suite and EMR system navigation

Preferred Qualifications

• 6+ years of clinical experience in long-term care or senior living preferred
• RAC-CT/RAC-CTA certification
• Experience with training and EHR optimization in PointClickCare and/or MatrixCare
• Background in SNF billing, appeals management, ADR responses, or reimbursement review practices
• Licensed Nursing Home Administrator

About Forvis Mazars, LLP

Forvis Mazars, LLP is an independent member of Forvis Mazars Global, a leading global professional services network. Ranked among the largest public accounting firms in the United States, our 7,000+ team members deliver assurance, tax, and consulting services to clients in all 50 states and internationally. With a legacy spanning more than 100 years, we're building something different. We are guided by a shared promise: Together, we create extraordinary experiences. That means delivering an Unmatched Client Experience® while creating a workplace where relationships matter, learning fuels growth, and every person feels valued and supported to thrive.

What We Offer

Our robust total rewards program and flexible work environment reflect our commitment to people, careers, and well-being-empowering our team to grow and thrive while delivering exceptional service. To explore what makes working at Forvis Mazars special, visit www.forvismazars.us/careers.

Legal Notice

Forvis Mazars, LLP is an equal opportunity/affirmative action employer in accordance with applicable law. Employment selection and related decisions are made without regard to age, race, color, sex, sexual orientation, national origin, religion, genetic information, disability, protected veteran status, gender identity, or other protected classifications. It is Forvis Mazars, LLP standard policy not to accept unsolicited referrals or resumes from any source other than directly from candidates. Forvis Mazars, LLP expressly reserves the right not to accept any unsolicited referrals, resumes or CVs from vendors including and without limitation, search firms, staffing agencies, fee-based referral services, and recruiting agencies. Forvis Mazars, LLP further reserves the right not to pay a fee to a recruiter or recruiting agency unless such recruiter or recruiting agency has a signed vendor agreement with Forvis Mazars, LLP. Any resume(s) or CV(s) submitted to anyone working for Forvis Mazars, LLP, or submitted to a Forvis Mazars, LLP general email, without having a Forvis Mazars, LLP vendor agreement in place, will be considered the property of Forvis Mazars, LLP.