RN Clinical Reimbursement & MDS Specialist

PruittHealth; Savannah, Northern (GA, KY); Hybrid; USD 90,000 - 120,000; Full time

Job summary

PruittHealth seeks a Clinical Reimbursement Consultant RN to coordinate training and audits relating to RAI, MDS and reimbursement processes. You will advise on care plans, MDS accuracy and regulatory compliance across multiple facilities.

Requirements include a current RN license, MDS experience, and familiarity with MatrixCare and Pointright. Travel may be required, with a focus on process improvement and data-driven decision making.

Qualifications

• Current RN or allied health professional licensed in the state of residence.
• Credential Nurse Assessment Coordinator preferred.
• Experience with MDS and care planning.
• Knowledge of RAI, PPS and reimbursement systems.

Responsibilities

• Coordinate training for center partners and audits.
• Provide information on clinical and financial reimbursement status.
• Engage in PI activities and process improvement.
• Educate partners on RAI, Care Plan, Medicare PPS and State Case Mix.
• Oversee orientation for new CMDs and ensure privacy of resident data.
• Travel as needed, including overnight.

Skills

RAI knowledge

MDS experience

Regulatory knowledge

Healthcare analytics

Education

Bachelor's degree in Nursing

Tools

MatrixCare

Pointright

Job description

PruittHealth seeks a Clinical Reimbursement Consultant RN to coordinate training and audits relating to RAI, MDS and reimbursement processes. You will advise on care plans, MDS accuracy and regulatory compliance across multiple facilities.

Requirements include a current RN license, MDS experience, and familiarity with MatrixCare and Pointright. Travel may be required, with a focus on process improvement and data-driven decision making.