Senior Director of Clinical Reimbursement Operations

MDS Solutions; Sioux Falls (SD); Remote; USD 90,000 - 130,000; Full time

Job summary

A leading company in healthcare is seeking a Senior Director of Clinical Reimbursement Operations to oversee MDS Coordinators and financial operations. This role involves managing client relations, ensuring compliance, and providing education to staff. The ideal candidate will have a strong clinical background, leadership skills, and the ability to drive performance and satisfaction in a remote work environment.

Benefits

Creative, fun, and flexible working environment

Competitive salaries

Bonuses

Promotion opportunities

Comprehensive health, dental, and life insurance

401K with match

Mileage and licensure reimbursements

Flexible Spending Account

HSA

Qualifications

• Minimum 5 years in a clinical position, with 3+ years in RAI process.
• Current and unrestricted RN or Therapist (OT, PT, SLP) license.
• Knowledge of PDPM and State Case Mix Reimbursement systems.

Responsibilities

• Provide supervision for MDS Solutions staff, including hiring and performance management.
• Conduct regular audits of MDS coordinators to ensure compliance with standards.
• Maintain client relations through meetings and reports to review performance.

Skills

Critical thinking

Decision-making

Leadership

Interpersonal skills

Communication

Customer service

Initiative

Innovation

Creativity

Education

Bachelor’s degree in nursing or therapy discipline

Current RAC-CT certification

Tools

Microsoft Office

Billing software

Job description

Overview

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
• Benefits including competitive salaries, bonuses, promotion opportunities, meaningful work, reasonable hours, CE opportunities, paid time off, comprehensive health, dental, and life insurance, 401K with match, mileage and licensure reimbursements, Flexible Spending Account, and HSA.

Responsibilities

1. Provide supervision for MDS Solutions staff, including hiring, performance management, and terminations.
2. Manage scheduled billing hours for each MDS Coordinator under supervision and provide ongoing feedback.
3. Assist in orientation and onboarding of new MDS coordinators, tracking all training activities.
4. Identify training and performance needs; create targeted improvement plans.
5. Conduct regular audits of MDS coordinators to ensure compliance with standards.
6. Maintain client relations through meetings and reports to review performance and satisfaction.
7. Advise VP of Consulting Operations on client concerns and follow through with corrective actions.
8. Stay current with professional standards, MDS changes, regulations, reimbursement, and quality reporting programs.
9. Establish billable hours expectations in collaboration with VP of Consulting Operations.
10. Assist with other duties as directed by VP of Consulting Operations.

Qualifications

• Bachelor’s degree in nursing or therapy discipline
• Minimum 5 years in a clinical position, with 3+ years in RAI process
• Current and unrestricted RN or Therapist (OT, PT, SLP) license
• Current RAC-CT certification
• Strong critical thinking, decision-making, and judgment skills
• Intermediate proficiency in Microsoft Office; ability to learn billing software
• Strong leadership and interpersonal skills
• Knowledge of PDPM and State Case Mix Reimbursement systems
• Understanding of Medicare, Managed Care, and relevant regulations
• Effective communication skills, including articulating complex assessments
• Excellent customer service skills
• Initiative, innovation, and creativity
• Reliable transportation, valid driver’s license, and ability to travel occasionally

Key Rehab is an equal opportunity employer/service provider.