We are seeking a Regional Director of Clinical Reimbursement to oversee and support the MDS, PDPM, and quality measure processes across multiple skilled nursing facilities. This is a remote position with regular travel to facilities required for training, audits, and coverage as needed.

In times of staff vacancies at the facility level, this role is expected to step in and ensure operations continue seamlessly-making it feel like no one is missing. If you're proactive, detail-oriented, and passionate about both compliance and outcomes, this role is for you.

Key Responsibilities

Ensure compliance with state and federal regulations (RAI, PDPM, CMS, etc.)
Manage accurate and timely MDS submissions and data integrity
Support billing accuracy and optimize reimbursement outcomes
Conduct audits and develop corrective action plans as needed
Deliver staff training on MDS, clinical documentation, and quality measures
Analyze trends in quality measures and reimbursement performance
Serve as a liaison between clinical, administrative, and billing teams
Provide hands-on support during staffing gaps to maintain operational continuity
Prepare and deliver reports on regional performance

Qualifications

Active nursing license required (RN preferred; multi-state license preferred)
Minimum 3 years of experience in MDS and clinical reimbursement (regional experience a plus)
Strong knowledge of PDPM, RAI guidelines, CMS quality measures, and reimbursement practices
Ability to train and mentor facility staff
Strong organizational and communication skills
Willingness and ability to travel within the assigned region regularly
Proficient with EMR/MDS systems and Microsoft Office

Work Environment

Remote work with field-based travel
Must be able to respond to urgent needs at facilities in a timely manner
Occasional evening or weekend support may be required during audits or coverage situations

Apply today to join a mission-driven team focused on quality outcomes and operational excellence.

Aventura Health Group

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Regional Director of Clinical Reimbursement (RN Preferred)