Divisional Vice President of Clinical Reimbursement

Description

We are on Fire! Ignite Medical Resorts is growing, and we are excited to announce our expansion in the Charlotte, North Carolina region, launching in Spring of 2026

If you want to work with a company who values and appreciates its employees, join Ignite Medical Resorts and help us to Extinguish the Stereotype! We are a state of the art rehabilitation resort where we combine uncompromising luxury, never before seen amenities, and the highest quality care to provide a superior rapid rehabilitation experience.

Our Divisional VP of Clinical Reimbursement is responsible for:

Strategic Leadership and Oversight-Provides strategic direction for the organization’s clinical reimbursement programs across assigned facilities in our North Carolina and Oklahoma Regions.

Ensures system-wide strategies are followed to optimize Medicare and Medicaid reimbursement through accurate clinical assessment, documentation, and coding practices.

Serves as the divisional expert and advisor on clinical reimbursement regulations, trends, risks, and operational implications.

Collaborates with facility leadership, including Clinical Operations, Finance, and Revenue Cycle, to align reimbursement strategy with organizational goals.

Clinical Reimbursement Management and Optimization-Oversee the accuracy, completeness, and timeliness of MDS assessments and supporting clinical documentation across assigned facilities.

Provides leadership and guidance on PDPM performance optimization, including case mix index (CMI) management and clinical documentation improvement.

Monitors reimbursement metrics, trends, and performance indicators to identify opportunities for improvement and risk mitigation.

Leads initiatives to improve reimbursement

Regulatory Compliance and Risk Management-ensures compliance with all federal and state regulations to the RAI process, PDPM, Medicare, Medicaid other reimbursement systems.

Education, Training, and Leadership Development to our MDS Coordinators and interdisciplinary teams.

Performance Monitoring and Quality Improvement

Follows monitoring systems to evaluate reimbursement accuracy, case mix performance, and documentation effectiveness.

Identifies trends, gaps, and opportunities through data analysis and performance reviews.

Participates in Quality Assurance and Performance Improvement (QAPI) initiatives related to reimbursement

Supports root cause analysis and corrective action planning to address reimbursement and documentation deficiencies.

Aligns reimbursement practices with CMS Quality Measures and Five-Star Quality Rating performance.

Operational Collaboration and Organizational Support

Partners with Clinical Operations, and facility leadership to support reimbursement performance.

Provides consultation and guidance during facility transitions, acquisitions, and operational changes.

Supports implementation of reimbursement-related systems, workflows, and process improvements.

Collaborates with Finance and Revenue Cycle teams to ensure accurate reimbursement forecasting and revenue integrity.

Travel and Field Support

Conducts facility visits and reimbursement reviews to ensure compliance and operational effectiveness.

Provides on-site support, training, and performance evaluation as needed.

Maintains visibility

Awesome Benefits that Ignite Team Members can expect:

· COMPETITIVE WAGES

· GENEROUS BENEFITS PACKAGE INCLUDING HEALTH, DENTAL & VISION

· 401K PLAN WITH EMPLOYER MATCH

· PAID TIME OFF

· HOLIDAY PAY

· VOLUNTARY BENEFITS - LIFE/AD&D, STD, LTD, CRITICAL ILLNESS, ACCIDENT, HOSPITAL INDEMNITY

· SHORT-TERM AND LONG-TERM DISABILITY

· EMPLOYEE ASSISTANCE PROGRAM (EAP)

· HEALTH SAVINGS ACCOUNT (HSA)

· EMPLOYER PAID LIFE INSURANCE

· RASMUSSEN COLLEGE 20% DISCOUNT FOR IN PERSON CLASSES

· HOSPITALITY AND TEAMWORK FOCUSED CULTURE

· 50% OFF IN OUR ON-SITE RESTAURANT AND LUXECAFE PROUDLY SERVING STARBUCKS

· A COMMITMENT TO TECHNOLOGY

· FREE PLANET FITNESS MEMBERSHIP

· ON DEMAND PAY

· COMPANY SPONSORED DOORDASH DELIVERY SERVICE

· ADVANCEMENT OPPORTUNITIES

· SUPER PERKS PROGRAM PET INSURANCE 12%-30% DISCOUNTS

· SUBSIDIZED CHILD CARE BENEFITS

Ignite Medical Resorts is an Equal Opportunity Employer.

Requirements

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below are representative of the knowledge, skill, and/or ability required.

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Must possess a current, unencumbered, active license to practice as an RN/LPN/LVN in the state of operation.

• Must be able to read, write, speak, and understand the English language. With the ability to read and interpret documents, write reports, and correspondence

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Strong understanding of CMS, Medicare, Medicaid, and state regulatory frameworks governing skilled nursing reimbursement.

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Demonstrated ability to identify reimbursement risk areas and implement corrective action plans that align with organizational compliance standards.

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Must be able to make independent decisions when circumstances warrant such action.

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General knowledge of professional nursing, restoratives, and personal care services

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Valid driver’s license, required

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5 years management experience in Long Term Care is preferred.