Description

Who We Are:

Hooverwood Living is a renowned senior living community nestled in the heart of Indianapolis, Indiana. With a rich history spanning over a century, we have been dedicated to providing exceptional care and support to older adults since our establishment in 1902. At Hooverwood Living, we pride ourselves on creating a warm, welcoming environment where residents can thrive and enjoy a fulfilling lifestyle. Our compassionate and highly skilled team is committed to delivering personalized care that honors the unique needs and preferences of each individual. Whether it's assistance with daily activities, specialized memory care, or simply companionship and support, we are here to ensure that every resident receives the highest quality of care and attention. 

Why Work for Hooverwood Living? 

Hooverwood Living is more than a job - we are a family where your passion for caring makes the difference we need. We value our diverse team and take pride in being an equal opportunity employer. We are accessible by public transportation. We specialize in skilled nursing, short term rehabilitation, and dementia care. 

We offer a competitive salary and excellent benefits with includes: medical, dental, vision, STD, LTD, PTO, referral program, employee payroll deduct for Market place Café and purchasing of uniforms , JCC member discount, 401k and match, and many more benefits.

Competitive pay & benefits! Flexible schedules & work life balance. Great place to work! Make the Hooverwood difference!

If you are looking for a career boost, Hooverwood is looking for you!

Essential Duties and Responsibilities of the Director of Clinical Reimbursement:

• Develop and implements case management and clinical reimbursement programs.
• Review weekly/monthly RUG distribution/reimbursement reports. assist in identification of trends.
• Provide instruction to the Facility MDS Coordinators on the RAI Processes and Systems.
• Track, trend and analyze current RUG scores. end splits. CMI on a weekly and monthly basis and report to the management team.
• Assist in developing a plan of action to improve the clinical reimbursement / RAJ functions and processes at the Facilities level.
• Serve as the subject matter expert for the Company on all areas related to Clinical Reimbursement and RAI.
• Serve as the Liaison reviewing RUGs utilization, Forecasts, ADL Index and Reimbursement Utilization.
• Collaborate with the Company Chief Compliance Officer to ensure adherence to company’s policies and procedures plus Federal and State Regulations.
• Partner with Medical Review to ensure that accurate ADR information is submitted to the fiscal intermediaries.
• Maintain Current information on OBRA regulations, licensure requirements, and other regulatory and agency standards.
• Assesses the knowledge, skills, techniques, procedure and performance of the nursing MDS and staff as it relates to coding of the MDS and related assessments.
• Trains the MDS staff on the appropriate CAAs and trigger worksheets and assessment reference dates.
• Serves as the subject matter expert for the company on all areas related to clinical reimbursement.
• Assist in identification development and implementation of education opportunities.
• Coordinate with other functional executives and managers to properly scope projects, coordinate their execution across functions and develop training and educational programs as required. Manage change control.
• Facilitates audits generated by outside affiliates.
• Reviews new orders daily for compliance and appropriate follow through.
• Leads weekly Medicare meeting.
• Attends daily IDT, clinical and other Department meetings during the week that relate to clinical reimbursement and outcomes.
• Oversees the facility Restorative Program.
• Audit therapy minutes daily to ensure highest reimbursement and burden of care are captured.
• Audit ADL grids daily to determine if MDS ARD needs to be reset in order to capture highest burden of care.
• Review the Rug Analysis report daily to identify new areas of opportunity to capture higher burden of care.
• Performs any other duties, as may be assigned by the Administrator.

Requirements

Must be a RN (with active Indiana license). 

Physical or Mental Functions Required to Perform Job: (1) Must function effectively under timelines and multiple demands; (2) must be able to fully and effectively communicate orally and have the ability to write or type; (3) must be able to read normal print/script and computer-generated type; (4) must have the ability to hear/see effectively.