Clinical Reimbursement Director

2 days ago

Westerville, Ohio, United States Ciena Healthcare Full time
Director of Clinical Reimbursement Job Description

Ciena Healthcare is seeking a highly skilled and experienced Director of Clinical Reimbursement to join our team. As a key member of our organization, you will be responsible for leading the development and implementation of clinical reimbursement strategies that drive quality care and financial performance.

Key Responsibilities:
  • Develop and maintain a deep understanding of state-specific quality incentives and reimbursement policies related to clinical documentation.
  • Provide strategic direction and analysis to clinical teams to drive quality improvement and financial performance.
  • Collaborate with corporate, regional, and facility interdisciplinary teams to ensure seamless execution of clinical reimbursement strategies.
  • Travel to our skilled nursing facilities in Ohio, Indiana, Virginia, and North Carolina to provide on-site support and guidance.
  • Develop and maintain relationships with key stakeholders, including corporate, regional, and facility leaders.
  • Stay up-to-date on industry trends and best practices in clinical reimbursement and quality improvement.
Requirements:
  • Active RN license in state of residence or state(s) of practice.
  • NAC Certification.
  • Minimum 5+ years' experience with RAI process and PPS at the regional level or above.
  • Multi-facility experience preferred with Ohio, NC, VA, and IN state-specific experience.
  • Demonstrate and understand value-based payment and case mix reimbursement methodology.
  • Ability to travel up to 50%.
About Ciena Healthcare:

Ciena Healthcare is a national organization of skilled nursing, subacute, rehabilitative, and assisted living providers dedicated to achieving the highest standards of care in five states. We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them.

We are an equal opportunity employer and welcome applications from diverse candidates. If you are passionate about improving the lives of those around you and working with others who feel the same way, we encourage you to apply for this exciting opportunity.

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