Chicago Jobs | Director of Clinical Reimbursement Jobs
Director of Clinical Reimbursement
Industry leadership has its advantages.
Vi is the parent organization of ten exclusive continuing care retirement communities (CCRC) in some of the nation's most desirable locales. Vi is a place where self-directed professionals apply entrepreneurial passion to corporate vision and strategy, across functions, building our premium brand into something irresistible. For those compelled by superior performance and driven to find the better way, working at Vi will bring new life to your career!
Director of MDS
The professional selected for this role provides company-wide guidance and support to the MDS Coordinators, Directors of Nursing and other Care Center clinical leaders to ensure the accuracy and completion of Minimum Data Set (MDS) and Resident Assessment Instrument (RAI) processes, care plans, and medical records by monitoring adherence to federal and state regulatory requirements and standards for MDS and billing accuracy.
Principal responsibilities include:
- Assists the AVP of Quality and Clinical Excellence in developing and establishing consistent best practice throughout the continuum of care for Medicare compliance and quality related services and processes.
- Monitors changes to federal Medicare standards for Skilled Nursing and assists with the development and implementation of policies, processes, and corporate objectives to ensure corporate and community compliance with federal regulations.
- Assures that community MDS Coordinators complete MDS assessments, develop resident care plans, and conduct care plan conferences per regulatory standards and company policy and procedure.
- Identifies community quality assurance and program development needs by monitoring clinical goals and implementing solutions to meet community quality objectives (i.e. 5-star rating).
- Provides clinical leadership related to the RAI process, guidelines and standards and ensures accuracy of coding and capturing all applicable aspects of care delivery.
- Develops, coordinates, and conducts educational in-services and training as needed for MDS Coordinators and community leadership teams based on regulatory changes, audit findings, and clinical and Medicare compliance outcomes reports.
- Conducts clinical documentation and technical audits and reports on findings with performance improvement plan recommendations.
- Up to 30 % travel required.
Qualified applicants are required to possess a Bachelor's degree in nursing. Must have prior experience establishing standards and implementing programs and systems for clinical care, service, and Medicare compliance initiatives. A minimum of 7 years of experience as an MDS Coordinator and knowledge of Medicare regulations is required. Minimum 3 years of experience in a regional MDS Nurse Specialist role in a skilled nursing venue is preferred. Current State Licensure in the state where practicing. Resident Assessment Coordinator certification is preferred or must be acquired within 18 months of hire as a condition of employment.
Part of a fulfilling career is not just doing work you love, but doing it alongside (and for) people you admire. Ours is a luxury work environment where opportunities for career development are delivered in ways few companies can match. Vi offers competitive compensation and exceptional benefits.
Bring life to your career.