Director of Clinical Documentation and Reimbursement
3 weeks ago
Location: Bronx, NY 10471
Schedule: Mon- Fri from 9am-5pm
Compensation: $135K- $150K
Company Overview
Client serves over 18,000 people every day, both in the greater New York community and on a gorgeous 32-acre campus just minutes from Manhattan. This park-like community offers sweeping views of the Hudson River and walkable trails, featuring its own world-class art collection and outdoor sculptures.
Recognized as one of the best long-term care communities in the country with dozens of accolades, we push the boundaries of what’s possible in long-term care. Innovative programs such as vision care, therapeutic activities, college courses, memory care, and exercise programs are underscored by individual attention and commitment to our residents. This dedication to detail and personalization makes a tangible difference in residents’ quality of life.
Responsibilities
- This position is responsible for the overall operational and strategic planning of the Clinical Documentation and Reimbursement (CDR) Department and Health Information Management (HIM) Department.
- This position will ensure that all the operational and regulatory requirements are maintained related to the Resident Assessment Instrument (RAI) process.
- Collaborates with other department heads to utilize objective information from the clinical documentation to drive the highest quality of care.
- Leads the strategic planning development related to Medicare/ Medicaid reimbursement and Managed Care Case Management.
- Monitors and incorporates facility wide education plans related to MDS updates, payment reforms and changes to quality measures.
- Analyzes and tracks data related to MDS item sets to support organizational quality assurance/ performance improvement plan.
- Audits and tracks all aspects of the RAI process to ensure performance is reflective of NYS DOH regulatory statues and standards.
- Provides oversight and supervision to all CDR and HIM staff.
Qualifications
This position requires a Bachelor's Degree in Nursing or a Master’s Degree preferred. NYS RN License in related healthcare field a plus.
- Bachelor’s Degree in Nursing required, Master’s Degree preferred.
- NYS RN license required with required following experience a plus:
- Minimum 3 years of Resident Assessment Instrument (RAI) process and SNF reimbursement experience.
- Completion of New York State approved PRI assessor program preferred, RAC-CT preferred.
- Knowledge of Federal and State regulations and NYS nursing standards required. Familiarity with Medicaid and Medicare regulations required.
- Required Experience with data extraction and manipulation required.
- SNF Based Quality Metrics (ie QM, QRP, VBP models)
- Demonstrated strong analytical, project management Skills.
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