Regional Reimbursement Director: LTC/MDS & Medicare Expert

American Medical Associates; New York (NY); On-site; USD 140,000 - 150,000; Full time

Job summary

American Medical Associates seeks a Regional Director of Reimbursement for SNF/LTC facilities, based in Utica, NY, with leadership across NYS. Salary ranges $140K-$150K, depending on experience. The role emphasizes extensive training, compliance oversight, and improvement of Medicaid/Medicare payment processes.

The candidate will travel regionally, provide expert guidance, perform audits, and collaborate with state and facility teams to optimize case-mix and reimbursement outcomes.

Qualifications

• Must hold valid New York RN license.
• MDS experience across multiple facilities in long-term care.
• Extensive knowledge of Medicare reimbursement, case mix, and PDPM/QM.
• Regional MDS experience preferred; travel required.

Responsibilities

• Provide training, analysis, advice and consultation to facilities and teams.
• Ensure compliance with federal and state regulations, policy and procedures for payment systems.
• Monitor and recommend changes to improve Medicaid/Medicare/Managed Care payment performance.
• Consult and support on Medicare, Managed Care and state case mix systems.
• Audit MDS assessments and supporting documentation for compliance.
• Liaise with state and organization on state case-mix processes and submissions.
• Assist in recruitment for MDS and MMQ vacancies.

Skills

RN License

MDS Experience

CMI/PDPM Knowledge

Travel Willingness

Job description

American Medical Associates seeks a Regional Director of Reimbursement for SNF/LTC facilities, based in Utica, NY, with leadership across NYS. Salary ranges $140K-$150K, depending on experience. The role emphasizes extensive training, compliance oversight, and improvement of Medicaid/Medicare payment processes.

The candidate will travel regionally, provide expert guidance, perform audits, and collaborate with state and facility teams to optimize case-mix and reimbursement outcomes.