Vice President of Reimbursement Strategies
2 weeks ago
Position Title:
Vice President of Reimbursement Strategies
Location:
Assigned to various locations in North Carolina
Required Experience in Healthcare Settings:
Long-Term Care Facilities
Nursing Homes
Rehabilitation Centers
Assisted Living Facilities
Skilled Nursing Facilities
Key Responsibilities:
Possess a comprehensive understanding of the RAI process, including the Minimum Data Set, Care Area Assessments, Resident Care Plans, Medicare Part A, and case mix documentation requirements.
Have familiarity with the 5-Star Quality Rating System.
Hold a degree from an accredited nursing institution.
Maintain a current RN license in North Carolina with multi-state privileges.
Have a minimum of 3 years of experience with MDS 2.0.
Possess at least 3 years of experience in multi-facility consulting and regional leadership roles.
Qualifications:
Demonstrate the ability to plan, organize, develop, and implement training programs for the effective operation of the Resident Assessment Instrument and reimbursement processes, adhering to current federal and state standards, guidelines, and regulations, as directed by the Senior Vice President of Health Services.
Exhibit the capability to create and design educational programs for corporate and facility staff covering all aspects of the Resident Assessment Instrument (RAI) process, clinical reimbursement, and the 5-star quality measure rating system.
Oversee and support the Clinical Reimbursement Director and Regional MDS Consultants in conducting thorough evaluations of the RAI and related documentation to ensure compliance with regulatory and reimbursement standards.
Demonstrate initiative, judgment, and management skills to identify and manage reimbursement trends for Medicare Part A, Medicare Part B, Medicare Advantage Plans, and Medicaid.
Guarantee the accuracy of MDS reporting data in relation to the 5-Star quality measure rating system, collaborating with facility and regional leadership to improve quality outcomes.
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