Area Director of Clinical Reimbursement
3 weeks ago
Overview
Diversicare is a premier provider of post-acute care services to patients and residents at 43 skilled nursing and long-term care centers in five states. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.
It is Diversicare's Mission to "Improve every life we touch by providing exceptional healthcare and exceeding expectations."
Diversicare has an exciting opportunity for an Area Director of Clinical Reimbursement. In this role you will provide guidance and consultation of all aspects of the RAI process to assist facilities in meeting regulatory compliance. Additionally provide subject matter consultation on Medicare, Medicaid and Managed Care reimbursement and regulatory guidelines.
Responsibilities
The key role of the Director of Clinical Reimbursement is to ensure that the RAI process at each facility is being completed/coordinated in a timely and accurate manner that is in compliance with federal and state regulations. In addition to these responsibilities, the following expectations, which are not all-inclusive, will guide the Area DCR:
Train and consult with RNACs and LNACs on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement. Train and consult with center staff and administration on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement. Function as the subject matter expert for the regional team on the RAI, Medicare, Medicaid and Managed Care processes Utilize Electronic Health Record and other available data systems to audit and monitor integrity of:
* PDPM HIPPS modifier trends
* RUG Trends in case mix states
* ALOS
* ADL Coding Accuracy
* Overall RAI process
* Identification and resolution of data integrity issues
* Medicare, Medicaid and Managed Care program requirements
* Medicare, Managed Care and Medicaid rates
Utilize Electronic Health Record and other available data systems to analyze and project Medicare, Managed Care, and Medicaid rates to facilitate accurate identification of provided services. Review and analyze QM reports, investigate trends, and assist facilities in development and completion of plans to influence improvement. Train and consult with centers on Medicare, Medicaid and Managed care Documentation Requests to ensure prompt response and corrective action. Support Centers in retention and recruitment of MDS staff:
* Complete second level interviews
* Orient and provide ongoing training
* Provide recommendations for performance assessment to administrator
Participate in Regional meetings and activities:
* Quality Reviews
* QAPI
Participate in Clinical Reimbursement Department Activities:
* Program Development
* Trainings
In the absence of a center NAC, Area DCR will provide direct center support which may include completion of tasks assigned to the NAC. This support may be onsite or remotely depending upon the need. Other duties as assigned by leadership.
Qualifications
1. Current RN license by State Board of Nursing.2. Minimum of 3 years' experience as an MDSC.3. Prior experience in multi-facility consultation.4. Excellent communication skills; prior experience in teaching/training preferred.5. Computer skills necessary.6. Must obtain AANAC RAC-CT certification within 1 year of acceptance of position or Relias CMAC certification.
-
Director of Palliative Care
5 days ago
Tupelo, United States Curo Health Services Full timeOur Company Empatia is a member of the Gentiva family - an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support to patients and their families so they may make the most of every moment. We believe that better care for caregivers and...
-
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff **Clinical**: * Assists in coordinating and providing care to patients across continuum of care, in conjunction with other health care...
-
Clinic Supervisor
7 days ago
Tupelo, United States One GI Full timeHave you been looking for a place to grow your skillset? Or perhaps you are looking for a place to develop your career surrounded by a diverse group where employees feel a sense of belonging. At Digestive Health Specialist we are championing the power of inclusivity and a people first mentality. We hope to improve the human experience from our patients to...
-
Clinic Supervisor
1 week ago
Tupelo, United States One GI® Full timeHave you been looking for a place to grow your skillset? Or perhaps you are looking for a place to develop your career surrounded by a diverse group where employees feel a sense of belonging. At Digestive Health Specialist we are championing the power of inclusivity and a people first mentality. We hope to improve the human experience – from our patients...
-
Tupelo, MS, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi. Job Description & Requirements Specialty: Clinic Discipline: RN Duration: Ongoing Employment Type: Staff **Clinical**: * Assists in coordinating and providing care to patients across continuum of care, in conjunction with other...
-
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff **Clinical:** * Provides athletic training services to area recreational groups, schools, and other organization as assigned * Assist...
-
Staff Nurse
5 days ago
Tupelo, MS, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Oncology for a nursing job in Tupelo, Mississippi. Oncology Employment Type: Staff **\*$3,000 sign on bonus available, external applicants only, OCN certification must be obtained within 2 years of hire date\* This position coordinates and provides direct patient care to ambulatory...
-
Staff Nurse
5 days ago
Tupelo, MS, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Oncology for a nursing job in Tupelo, Mississippi. Oncology Employment Type: Staff **\*$3,000 sign on bonus available, external applicants only, OCN certification must be obtained within 2 years of hire date\* This position coordinates and provides direct patient care to ambulatory...
-
Per Diem
12 hours ago
Tupelo, United States North Mississippi Health Services Full timeJob DescriptionNorth Mississippi Health Services is seeking a CNA Clinic for a per diem / prn job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: CNADuration: OngoingEmployment Type: Per DiemSupervisory:* Delegates authority to TechniciansClinical:* Maintains productivity level at department target* Evaluates and establishes...
-
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff **Supervisory:** * Supervises student interns and delegates authority to Rehabilitation technicians. **Clinical:** * Maintains...
-
Tupelo, United States North Mississippi Health Services Full timeJob DescriptionNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff Supervisory:* Supervises student interns and delegates authority to Rehabilitation technicians.Clinical:* Maintains...
-
Staff Pharmacist II- 7am-6pm, 7on/7off
1 month ago
Tupelo, United States North Mississippi Health Services Full timeStaff Pharmacist II- 7am-6pm, 7on/7off Job ID: UE Tupelo Clinical-Non Nursing - PHARMACY Full Time - Day Posting Description At North Mississippi Health Services, our mission is to continuously improve the health of the people of our region. Our vision is to provide the best patient and family-centered care and health services in America. We...
-
Per Diem
5 days ago
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a per diem / prn Pharmacist for a per diem / prn job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: PharmacistDiscipline: Allied Health ProfessionalDuration: OngoingEmployment Type: Per Diem **_Essential Functions_** _List major areas of responsibility and briefly what the person does in each...
-
Per Diem
3 days ago
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a per diem / prn Pharmacist for a per diem / prn job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: PharmacistDiscipline: Allied Health ProfessionalDuration: OngoingEmployment Type: Per Diem **_Essential Functions_** _List major areas of responsibility and briefly what the person does in each...
-
Per Diem
6 days ago
Tupelo, United States North Mississippi Health Services Full timeJob DescriptionNorth Mississippi Health Services is seeking a per diem / prn Pharmacist for a per diem / prn job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: PharmacistDiscipline: Allied Health ProfessionalDuration: OngoingEmployment Type: Per DiemEssential FunctionsList major areas of responsibility and briefly what the person does in...
-
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff **Basic Requirements:** **Nutritional Assessment/Care Plans:** * Assesses patients/residents as referred by the physician or nurse, as...
-
Per Diem
5 days ago
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a per diem / prn nurse RN Clinic for a per diem / prn nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Per Diem * Ability to perform a complete & accurate 2D Adult Echocardiogram across all main unit areas, including, but not...
-
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff **Patient Care:** A nationally registered paramedic who functions using assessment skills and written protocols to provide emergency care in a...
-
Tupelo, United States North Mississippi Health Services Full timeNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: Staff **Patient Care:** A nationally registered paramedic who functions using assessment skills and written protocols to provide emergency care in a...
-
Tupelo, United States North Mississippi Health Services Full timeJob DescriptionNorth Mississippi Health Services is seeking a Registered Nurse (RN) Clinic for a nursing job in Tupelo, Mississippi.Job Description & RequirementsSpecialty: ClinicDiscipline: RNDuration: OngoingEmployment Type: StaffPatient Care: A nationally registered paramedic who functions using assessment skills and written protocols to provide emergency...
