Director of Regulatory and Reimbursement Services

1 month ago

Lake Elmo, United States Pathway Health Full time
Position: Director of Regulatory and Reimbursement Services Location: all cities
Job Id: 425 # of Openings: 1 Experience the Positive, Innovative, and Flexible Culture at Pathway Health Services At Pathway Health Services, we believe in working hard and having fun. Our positive culture fosters an environment where innovation thrives, and we encourage our employees to think outside the box and come up with creative solutions to challenges. Our flexibility allows us to adapt to changing circumstances and provide our clients with the best possible service. Our commitment to positivity, innovation, and flexibility creates a workplace where everyone can thrive. Join us at Pathway Health Services and experience a culture that values your unique contributions and supports your growth. We are looking for a Regulatory and Reimbursement Director superstar to join our team If you want to be part of a forward thinking, family oriented and client focused organization, submit your resume now The Director of Regulatory and Reimbursement Services will oversee the products, resources, education and consulting services related to regulatory and reimbursement for our customers. This position is responsible for the development, oversight and support of consultation related to the regulatory processes/solutions in customer settings as well as reimbursement processes including the resident assessment process, quality measurement and data in accordance with state and federal requirements. This position will also lead a team of subject matter experts in the areas of MDS, CAA, PDPM, PPS, Case Mix QM's and care plan process. In addition, the Director serves as a regulatory resource/subject matter expert for the company and consultants in responding to customer regulatory needs as well as product and education development needs. The Director will also assist in the marketing of services, coordination of projects, consultant staffing, client development and employee/customer relations as needed. Qualifications should include:
  • BA/BS in designated area of specialty in addition to certification and/or credential.
  • Minimum of five years proven professional clinical/operational and/or consulting skills; long term care experience preferred.
  • Strong customer service skills to coordinate service delivery including attention to clients, sensitivity to issues, identification and resolution of issues to promote positive outcomes for clients; requires innovation and creativity.
  • Work requires continual attention to detail in composing, typing and proofing materials, establishing priorities and meeting deadlines.
  • Must be able to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks, demands and be responsive to staff and clients.
  • Critical thinking skills with the ability to make good decisions and exercise sound clinical and professional judgment.
  • Considerable independent judgment is required to carry out assignments that have significant impact on services or programs.
  • Must maintain all professional licenses and certifications as required and provide proof of current licensure.
Special Position Requirements:
  • Must be able to operate a motor vehicle, maintain a current driver's license and provide proof of auto insurance indicating coverage for uninsured motorist.
  • Travel is required (up to 25%)
Pathway Health is an EEO/AAP employer
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Pathway Health is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

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