What are the responsibilities and job description for the Director of Facility Based Clinical Reimbursement position at Hillcrest Health Services?
Director of Facility-Based Clinical Reimbursement
Hillcrest Health & Living is seeking an experienced and strategic Director of Facility-Based Clinical Reimbursement (RN) to lead and oversee all reimbursement-related functions across our post-acute and long-term care communities. This individual will serve as a key resource for ensuring compliance, accuracy, and optimization of the MDS and PDPM processes, while supporting our mission of Inspiring people to live their best lives.
Key Responsibilities
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Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.
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Ensure accurate, timely completion and submission of MDS assessments in accordance with federal and state regulations.
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Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.
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Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer-specific reimbursement systems.
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Develop and implement policies and procedures to ensure consistent documentation and coding practices.
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Partner with clinical and financial leaders to align care documentation with reimbursement compliance.
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Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.
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Support education, training, and competency development for facility reimbursement teams.
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Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.
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Represent the reimbursement department in interdisciplinary and corporate-level meetings.
Qualifications
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Current Registered Nurse (RN) license in the state of Nebraska (or compact state).
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Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.
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Prior experience in post-acute care, long-term care, or skilled nursing facility management required.
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Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and clinical documentation requirements.
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Proven ability to lead, educate, and mentor multi-site clinical reimbursement teams.
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Excellent analytical, organizational, and communication skills.
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Ability to travel periodically between facilities.
Why Hillcrest
At Hillcrest, we believe in providing a career that helps you thrive—both professionally and personally. We offer:
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Comprehensive health, dental, and vision insurance options
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Paid time off
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Tuition reimbursement and student loan repayment for nurses
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Career growth and development opportunities
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A mission-driven culture centered on Integrity, Compassion, Respect, Teamwork, and Service