Clinical Director of Assessment and Reimbursement

6 days ago

Lemont, Illinois, United States Franciscan Ministries Full time
Job Summary

We are seeking a highly skilled and experienced Clinical Director of Assessment and Reimbursement to join our team at Franciscan Ministries. This is a field-based position that requires travel to different communities, and the ideal candidate will have a strong background in clinical leadership, including multi-site experience.

Key Responsibilities
  1. Leadership and Oversight
  • Oversee the MDS department across Franciscan Ministries Skilled Nursing Communities.
  • Ensure that MDS has proper and sufficient training to ensure the best PDPM and CMI outcomes for resident's acuity and maximize revenue.
Quality and Compliance
  • Drive Quality Measure goals to account for the quality of care provided to residents.
  • Ensure compliance with CMS, Medicare and federal guidelines.
Reimbursement and Operations
  • Assist centers in the triple check process.
  • Implement/update policies and procedures related to reimbursement and care planning.
  • Oversee and monitor the center's ADR (Additional Documentation Request) processes.
  • Ensure PBJ hours are correct and submitted per federal regulations.
Training and Development
  • Train and coach new and current MDS nurses.
Requirements
  1. Licensed Registered Nurse.
  2. 5+ years of experience in clinical leadership, including multi-site.
  3. 5+ years of experience as a Resident Assessment Coordinator.
  4. High degree of business aptitude, strategic thinking and creative abilities.
  5. Strong communicator and capable of managing and leading.
  6. Ability to multi-task and is able to prioritize projects and deadlines.
Working Conditions
  1. This is a field-based position traveling to different communities in all operating locations.
  2. Must be effective in functioning in a team approach regardless of the work environment.
  3. Must be able to function independently and demonstrate flexibility and personal.
  4. The Director Clinical Assessment & Reimbursement is in contact with peers, residents, associates, visitors, and family members.
  5. Ability to travel 45% of the time.
Physical Demands
  1. Must be able to move intermittently throughout the workday.
  2. Ability to stand, walk, bend, and lift.
  3. Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately.
  4. Must meet the general health requirements set forth by the policies of this community.
Mental Acuity Requirements
  1. Must function independently and have flexibility, personal integrity, and the ability to work effectively with the residents, personnel, and support.
  2. Must possess the ability to make independent decisions when circumstances warrant such.
  3. Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general.
  4. Must be knowledgeable of healthcare regulations, laws, and guidelines governing the long-term care.
  5. Must possess leadership ability and willingness to work harmoniously with other personnel.
Technical/Motor Skill Requirements
  1. Must be able to speak and write the English language in an understandable.
  2. Must be able to communicate with people of all professional and social.
  3. Must be proficient in Microsoft Office and other common software application, PCC experience preferred.

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