MDS & Reimbursement Strategy Director

Pioneer-Health-Care-Management-; Southfield Township (MI); On-site; USD 120,000 - 180,000; Full time

Job summary

Pioneer Healthcare Management is seeking a Clinical Director of Reimbursement in Michigan to lead MDS oversight and reimbursement programs. The role focuses on ensuring accurate MDS coding, PDPM classifications, and compliance with CMS and Medicaid regulations, while guiding facility teams through surveys and audits.

The position reports to the Director of Operations and requires collaboration with clinical and administrative leaders to drive optimal reimbursement outcomes across all facilities.

Responsibilities

• Provide leadership and oversight to all facility MDS Coordinators and Regional Clinical Teams.
• Standardize MDS processes across all facilities.
• Develop and implement corporate MDS policies and procedures.
• Ensure consistency with CMS regulations and company standards.
• Assist facilities during leadership transitions and vacancies.
• Provide on-site support during surveys, focused reviews, and regulatory investigations.
• Serve as the corporate expert for MDS, PDPM, and reimbursement.
• Monitor compliance through routine auditing and reporting.
• ARD management and assessment-related duties.
• Oversee PDPM classification and skilled documentation.
• Coordinate with CDI team on documentation accuracy.

Job description

Pioneer Healthcare Management is seeking a Clinical Director of Reimbursement in Michigan to lead MDS oversight and reimbursement programs. The role focuses on ensuring accurate MDS coding, PDPM classifications, and compliance with CMS and Medicaid regulations, while guiding facility teams through surveys and audits.

The position reports to the Director of Operations and requires collaboration with clinical and administrative leaders to drive optimal reimbursement outcomes across all facilities.