Regional Clinical Reimbursement Lead – PDPM & MDS

STGi; Wilmington (NC); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k with company match

Generous PTO policy

Job summary

STGi is seeking a Regional Clinical Reimbursement Consultant to lead PDPM and MDS processes across multiple long-term care facilities in the Wilmington region. The role emphasizes accuracy, compliance, and collaboration with clinical, financial, and operational leaders.

Extensive travel within the assigned region is required. The position requires a RN license (BSN preferred) with 5–7 years of MDS and clinical reimbursement experience and strong knowledge of CMS regulations.

Qualifications

• Active RN license in good standing.
• Bachelor’s degree in Nursing or related field (BSN required).
• 5–7 years of MDS and clinical reimbursement experience in long-term care.
• Strong knowledge of PDPM, RAI Manual, ICD-10 coding, and CMS regulations.

Responsibilities

• Oversee clinical reimbursement operations across multiple skilled nursing facilities.
• Ensure accurate, timely, and compliant completion of MDS assessments per CMS requirements.
• Monitor PDPM performance, case-mix accuracy, and reimbursement trends.
• Identify opportunities to optimize reimbursement while maintaining clinical integrity and compliance.
• Provide guidance to MDS Coordinators and facility leadership on documentation and CAAs.

Skills

MDS knowledge

PDPM understanding

CMS regulations

Analytical skills

Travel willingness

Leadership

Education

RN license

BSN

Job description

STGi is seeking a Regional Clinical Reimbursement Consultant to lead PDPM and MDS processes across multiple long-term care facilities in the Wilmington region. The role emphasizes accuracy, compliance, and collaboration with clinical, financial, and operational leaders.

Extensive travel within the assigned region is required. The position requires a RN license (BSN preferred) with 5–7 years of MDS and clinical reimbursement experience and strong knowledge of CMS regulations.