Director of Clinical Reimbursement and Quality Improvement

2 weeks ago


Lockport, New York, United States Laurel Health Care Company Full time
Job Summary

We are seeking a highly skilled and experienced Director of Clinical Reimbursement and Quality Improvement to join our team at Laurel Health Care Company. This is a key leadership role that requires a strong understanding of clinical reimbursement and quality improvement principles, as well as excellent leadership and communication skills.

Key Responsibilities
  • Leadership and Management
    • Provide strategic direction and leadership to clinical teams to improve quality and reimbursement outcomes.
    • Develop and implement policies and procedures to ensure compliance with regulatory requirements.
  • Clinical Reimbursement
    • Develop and maintain expertise in clinical reimbursement principles and regulations.
    • Provide education and training to clinical staff on clinical documentation and reimbursement best practices.
  • Quality Improvement
    • Develop and implement quality improvement initiatives to improve patient outcomes and reduce readmissions.
    • Collaborate with interdisciplinary teams to identify and address quality improvement opportunities.
  • Compliance and Risk Management
    • Ensure compliance with regulatory requirements and company policies and procedures.
    • Identify and mitigate risks associated with clinical reimbursement and quality improvement.
Requirements
  • Education
    • Active RN (Registered Nurse) license in state of residence or state(s) of practice.
    • Bachelor's degree in nursing (BSN) preferred.
  • Experience
    • 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.
  • Skills
    • Demonstrate and understand value-based payment and case mix reimbursement methodology.
    • Ability to travel up to 50%.


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