Clinical Reimbursement Director

2 weeks ago


Mansfield Tolland County CT, United States Evergreen Center for Health & Rehabilitation Full time

Evergreen Center for Health & Rehabilitation: A Leader in Long-Term Care

We are seeking a highly skilled Clinical Reimbursement Director to join our team at the Evergreen Center for Health & Rehabilitation. In this critical role, you will be responsible for managing the Minimum Data Set (MDS) assessments, ensuring revenue integrity, and compliance with state and federal regulations.

Key Responsibilities:

  • Lead and oversee the MDS program for accuracy and compliance
  • Determine Patient Driven Payment Method (PDPM) and associated expenses
  • Monitor Case Mix Index (CMI) scores for potential risks
  • Train, mentor, and manage MDS Coordinators
  • Coordinate and participate in comprehensive resident assessments and care planning
  • Provide education to facility staff and leaders
  • Analyze assessment data to identify opportunities for optimization

What We Offer:

  • Competitive compensation
  • Improved health insurance and retirement benefits
  • Comprehensive training and mentorship
  • Support for professional growth and development
  • A collaborative work environment

Qualifications:

  • Valid state RN license preferred
  • Advanced degree or certification preferred
  • Direct care in a long-term care setting and/or MDS Coordinator experience required
  • Proficient in state and federal regulations governing the MDS and billing process
  • Knowledge of Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid, and Medicare requirements
  • Excellent communication and interpersonal abilities
  • Ability to work effectively in a multidisciplinary team environment

We are an equal opportunity employer and welcome applications from all qualified candidates. We are committed to creating a diverse and inclusive work environment.


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