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Regional Director of Clinical Reimbursement

American Medical Associates • Full-time • N/A, OH, US • $100 - $135 / year • 2w ago

Regional Clinical Reimbursement

Throughout Cuyahoga County, OH and Franklin County, OH

*Salary: $100K-$135K per year (depending on experience)*

Responsibilities:

Ensures that the facility is in compliance with the organization’s policy and procedures and complies with all state regulations
Understands and implements company policies and procedures
Ensures the accurate and timely completion of all MDS Assessments including PPS Medicare, quarterly, annual, significant change.
Participates in care conferences as need or requested by facility
Performs comprehensive assessment on potential residents
Provides clinical training and support to all staff
Verifies electronic submissions of MDS, performs corrections when necessary and maintains appropriate records.
Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal and state standards.
Schedules and conducts resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews prior to resident care conference.
Assists disciplines in formulating and revising care plans. Ensures that resident’s present/potential problems are identified and prioritized; realistic goals are established and nursing intervention is appropriate.
Evaluates resident care plans for comprehensiveness and individuality.
Assesses the achievement or lack of achievement of desired outcomes. Ensures that resident’s care plan is reassessed and revised appropriately.
Responsible for all level of care changes within the facility. Notifies all departments when a level of care change has been made.
Generates appropriate forms to complete level of acuity and changes. Transmits forms to the appropriate agency for processing as required by state law.
Addresses complaints and resolves problems as needed.

Qualifications:

Must have an Ohio RN license
Must have experience as a Director of Clinical Reimbursement
Must have MDS experience
Must know MDS 3.0
Must have regional experience in nursing home
Must have long-term care/nursing home experience
Must have strong clinical background and knowledge
Must be willing to travel

#6919

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