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Director of Facility Based Clinical Reimbursement
DayforceDirector overseeing clinical reimbursement processes across Hillcrest's post-acute and long-term care communities. Ensuring compliance, accuracy, and optimization of MDS and PDPM systems.
About the role
Key responsibilities & impact- Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.
- Ensure accurate, timely completion and submission of MDS assessments in accordance with federal and state regulations.
- Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.
- Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer-specific reimbursement systems.
- Develop and implement policies and procedures to ensure consistent documentation and coding practices.
- Partner with clinical and financial leaders to align care documentation with reimbursement compliance.
- Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.
- Support education, training, and competency development for facility reimbursement teams.
- Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.
- Represent the reimbursement department in interdisciplinary and corporate-level meetings.
Requirements
What you’ll need- Current Registered Nurse (RN) license in the state of Nebraska (or compact state).
- Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.
- Prior experience in post-acute care, long-term care, or skilled nursing facility management required.
- Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and clinical documentation requirements.
- Proven ability to lead, educate, and mentor multi-site clinical reimbursement teams.
- Excellent analytical, organizational, and communication skills.
- Ability to travel periodically between facilities.
Benefits
Comp & perks- Comprehensive health, dental, and vision insurance options
- Paid time off
- Tuition reimbursement and student loan repayment for nurses
- Career growth and development opportunities
- A mission-driven culture centered on Integrity, Compassion, Respect, Teamwork, and Service