We rely on and trust our Regional Director of Clinical Reimbursement to provide extensive training, analysis, direction, action plan/resolution and consultation to the facilities, district and regional teams within his/her area of specialty. Validates compliance with federal and state regulations as well as Company policy and procedures regarding state case mix/Medicare payment systems, RAI process and operations.
Why Work For Us?
- Excellent pay with multiple incentives
- Excellent health benefits packages
- Career advancement opportunities
- Education reimbursement program of up to $7,500 per year
- Flexible scheduling available
Benefits Conditions:
- No waiting period for enrollment
- Three health plan options
- Delta Dental
- VSP Vision
- Free Basic Life Insurance
- Disability, Critical Illness, Accident Legal Coverage
- 401(k) Retirement Plan
- Employee Assistance Program
Responsibilities:
- Provides consultation, training and support related to the RAI Process. Medicare and state case mix payment system for assigned area with little supervision.
- Monitors, consults, and makes effective recommendations for changes and modifications to existing facility processes, systems, policies, and practices which will assure efficient, effective and compliant state Medicaid/Medicare payment performance and RAI process completion with minimal guidance.
- Responsible for training Registered Nurse Assessment Coordinator (RNAC) on accuracy and systems related to RUG mix, RAI process and Grouper calculation.
- Responsible for effective action plan resolution in areas of RAI process case-mix/Medicare system and action plans to necessary parties.
- Serves as a liaison between state and organization related to the state case-mix process, including electronic submission and state MDS requirements related to state payments.
Qualifications:
- RN or completion of a Bachelors Degree in a health care or related field
- Three to five years of clinical experience in a long term care setting, which includes supervisory, administrative, or consultative capacities
- Current knowledge of state case mix and Medicare payment systems
- Capable of maintaining regular attendance
- Must be able to work favorably across departments