Regional Clinical Reimbursement RN - Lead Systems & Outcomes

Avalon Health Care Group; Portland (OR); On-site; USD 120,000 - 140,000; Full time

Benefits offered by this job

401(k)

Medical, Dental & Vision

Flexible Spending Accounts (FSA)

Life Insurance

Short & Long-Term Disability

Critical Illness & Accident Coverage

Legal Benefits

Identity Theft Protection

Auto & Home Insurance Discounts

Job summary

Avalon Health Care Management, Inc. is seeking a Regional Clinical Reimbursement Specialist (RN) to support clinical and financial success across Oregon and Washington facilities.

You will collaborate with facility leadership on MDS/RAI, Medicare, and Medicaid reimbursement processes while driving quality outcomes and regulatory compliance. The role requires an active RN license and long-term care experience, with regional travel to multiple facilities.

Qualifications

• Current RN license.
• Long-term care experience required.
• MDS/RAI and Medicare/Medicaid reimbursement experience preferred.
• Willingness to travel regionally across WA/OR.

Responsibilities

• Provide leadership to facility teams on MDS, RAI, Medicare, and Medicaid reimbursement processes.
• Monitor facility systems to promote compliance, accuracy, and best practices.
• Analyze clinical and financial outcomes to identify improvement opportunities.
• Support Quality Measures, Five-Star initiatives, and reimbursement optimization efforts.
• Educate and mentor interdisciplinary teams across the region.
• Lead program development and process improvement initiatives.

Skills

RN license

Analytical skills

Leadership

Communication

Job description

Avalon Health Care Management, Inc. is seeking a Regional Clinical Reimbursement Specialist (RN) to support clinical and financial success across Oregon and Washington facilities.

You will collaborate with facility leadership on MDS/RAI, Medicare, and Medicaid reimbursement processes while driving quality outcomes and regulatory compliance. The role requires an active RN license and long-term care experience, with regional travel to multiple facilities.