Regional RN: MDS, Reimbursement & Compliance Lead

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

Benefits offered by this job

401(k)

Flexible Spending Accounts (FSA)

Life Insurance

Short & Long-Term Disability

Critical Illness & Accident Coverage

Identity Theft Protection

Auto & Home Insurance Discounts

Job summary

Avalon Health Care Management, Inc. is seeking a Regional Clinical Reimbursement Specialist (RN) to support reimbursement across Oregon and Washington facilities. This full-time role involves leading MDS/RAI processes, ensuring regulatory compliance, and driving quality outcomes with facility leadership.

Travel is required to multiple facilities, and the incumbent will mentor teams while improving systems and processes to enhance clinical and financial performance across the region.

Qualifications

• Current RN license and active status.
• Long-term care experience with MDS/RAI oversight.
• Strong analytical, communication, and leadership skills.
• Willingness to travel regularly across Washington and Oregon.

Responsibilities

• Provide leadership and guidance to facility teams on MDS, RAI, Medicare and Medicaid reimbursement processes.
• Monitor facility systems to ensure compliance, accuracy and best practices.
• Analyze clinical and financial outcomes to identify opportunities for improvement.
• 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

Analytical skills

Leadership

Communication

Education

Registered Nurse (RN) license

Tools

MDS/RAI knowledge

Job description

Avalon Health Care Management, Inc. is seeking a Regional Clinical Reimbursement Specialist (RN) to support reimbursement across Oregon and Washington facilities. This full-time role involves leading MDS/RAI processes, ensuring regulatory compliance, and driving quality outcomes with facility leadership.

Travel is required to multiple facilities, and the incumbent will mentor teams while improving systems and processes to enhance clinical and financial performance across the region.