Senior Director of Clinical Reimbursement Operations

MDS Solutions; Louisville (KY); Remote; USD 90,000 - 130,000; Full time

Job summary

MDS Solutions, a division of Key Rehabilitation, seeks a Senior Director of Clinical Reimbursement Operations to oversee the management of MDS Coordinators and ensure compliance with reimbursement policies. The role involves leadership, client relations, education, and continuous improvement of operations in a flexible work environment.

Benefits

Competitive salaries and bonuses

Flexible working environment

Paid time off

Comprehensive health, dental, and life insurance

401K with discretionary match

Mileage and licensure reimbursements

Creative and fun workplace

Qualifications

• 5 years’ experience minimum in a clinical position, with 3+ years experience with the RAI process.
• Strong knowledge in Medicare and Managed Care requirements.
• Critical thinking skills with the ability to make good decisions.

Responsibilities

• Oversee and manage MDS Coordinators and financial operations.
• Ensure compliance and reimbursement optimization.
• Provide ongoing education and training to MDS Coordinators.

Skills

Leadership

Clinical Judgment

Analytical Skills

Communication

Customer Service

Education

Bachelor’s degree in nursing or therapy discipline

Current RN or Therapist License

RAC-CT certification

Tools

Microsoft Office

Clinical and therapy billing software

Job description

Senior Director of Clinical Reimbursement Operations

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Senior Director of Clinical Reimbursement Operations

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MDS Solutions, a division of Key Rehabilitation, is looking for fun, energetic, and self-driven team members to join our remote MDS division as a Senior Director of Clinical Reimbursement Operations.

The Senior Director of Clinical Reimbursement Operations (SDCRO) is responsible for oversight and management of MDS Coordinators and financial operations within the division of MDS Solutions. The SDCRO will manage MDS coordination and client relations related to RAI assessments, reimbursement optimization, and Care Plan development in accordance with applicable laws, regulations, and company standards. The SDCRO will provide ongoing education and training to the MDS Coordinators to ensure that skills are in accordance with current reimbursement policies and federal quality reporting programs. They will audit for compliance and reimbursement optimization to ensure optimum client outcomes. The SDCRO performs well independently or with a team, utilizing clinical, analytical, communication, and customer service skills, as well as sound judgement and professionalism.

What do we offer you?

• Creative, fun, and flexible working environment
• The following benefits
• Competitive salaries and bonuses.
• Promotion/Transfer/Advancement opportunities.
• Meaningful work and job satisfaction.
• Reasonable working hours.
• CE opportunities.
• Paid time off.
• Comprehensive health, dental, and life insurance
• 401K with discretionary match
• Mileage and licensure reimbursements
• Flexible Spending Account and HSA
• Provide supervision for MDS Solutions staff, including hiring, performance management, and terminations.
• Responsible for scheduling and managing scheduled billing hours for each MDS Coordinator under his/her supervision. Provide ongoing, consistent feedback to each MDS Coordinator.
• Assist the Director of Education with conduct orientation and onboarding of new MDS coordinators; track all orientation timelines, materials, and on-going training for staff.
• Identify training and performance needs of MDS coordinators and create targeted plans with action steps for performance improvement.
• Complete regularly scheduled auditing of MDS coordinators to ensure that MDS coding and care planning meet state, federal, and MDS Solutions standards.
• Maintain client relations through regular meetings and weekly reports to review operational performance and ensure client satisfaction.
• Advise VP of Consulting Operations of client concerns, needs, and issues to be addressed. Follow through with agreed-upon plan of correction.
• Maintain current knowledge in professional standards of clinical care, MDS changes, federal and state statutes / regulations, federal and state reimbursement, and Federal Quality Reporting Programs.
• Work with VP of Consulting Operations to establish reasonable billable hours expectations per week for the SDOCRO position.
• Assist in other related duties, as directed by VP of Consulting Operations.
• Bachelor’s degree in a nursing or therapy discipline
• 5 years’ experience minimum in a clinical position, with 3+ years experience with the RAI process.
• Current and unrestricted RN or Therapist (OT, PT or SLP) License.
• Current RAC-CT certification.
• Critical thinking skills with the ability to make good decisions and exercise sound clinical and professional judgment, with proven knowledge of quality improvement concepts and processes.
• Intermediate level minimum skilled in Microsoft Office applications including Word, Excel, Power Point, and Outlook and ability to learn clinical and therapy billing software.
• Demonstrates strong leadership and interpersonal skills.
• Proficient knowledge of PDPM and State Case Mix Reimbursement payment systems.
• Strong knowledge in current Medicare and Managed Care requirements in addition to federal, state and local regulations that affect skilled clinical care delivery.
• Ability to work effectively with all persons and disciplines.
• Ability to articulate clearly the complexities of RAI assessments and Care planning.
• Strong customer service skills to coordinate service delivery, including attention to clients, sensitivity to issues, identification and resolution of issues to promote positive outcomes for clients.
• Initiative, innovation and creativity.
• Dynamic presentation skills and superior communication skills.
• Reliable transportation, with valid driver’s license, and abitity to operate a vehicle
• Occational travel required.
  
  
  

Key Rehab is an equal opportunity employer/service provider.

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Research, Analyst, and Information Technology

• Industries

  Hospitals and Health Care

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