Regional MDS & Reimbursement Leader

Avir Trilogy; El Paso (TX); On-site; USD 95,000 - 130,000; Full time

Job summary

Avir Trilogy is seeking a Clinical Reimbursement Manager to lead regional reimbursement operations for a portfolio of skilled nursing facilities. The CRM will drive Medicare Part A, PDPM, and Texas Medicaid PDPM-LTC alignment with clinical documentation and compliance.

This field-based role requires regular travel throughout the region and a strong facility presence, coordinating with Administrators, Directors of Nursing, MDS staff, and therapy teams to optimize reimbursement performance and

Qualifications

• RN license in good standing.
• 3–5 years skilled nursing MDS/clinical reimbursement experience.
• Strong knowledge of MDS 3.0/RAI and PDPM.
• Experience with Medicare Part A and reimbursement compliance.
• Proven leadership, communication, and training skills.
• Willingness to travel extensively in the region.

Responsibilities

• Provide reimbursement oversight for an assigned SNF portfolio.
• Monitor performance related to Medicare, Medicaid, and managed care.
• Develop regional strategies to improve reimbursement while ensuring compliance.
• Collaborate with facility leaders, MDS teams, and therapy providers.
• Conduct audits, education, and coaching at facilities.
• Deliver concise performance reporting to leadership.

Skills

RN license

MDS/clinical reimbursement

PDPM (Medicare Part A)

Texas Medicaid PDPM-LTC

MDS 3.0/RAI

Regulatory compliance

Leadership and coaching

Facility travel

Tools

PointClickCare

Job description

Avir Trilogy is seeking a Clinical Reimbursement Manager to lead regional reimbursement operations for a portfolio of skilled nursing facilities. The CRM will drive Medicare Part A, PDPM, and Texas Medicaid PDPM-LTC alignment with clinical documentation and compliance.

This field-based role requires regular travel throughout the region and a strong facility presence, coordinating with Administrators, Directors of Nursing, MDS staff, and therapy teams to optimize reimbursement performance and