Pdpm Audit Jobs in Ohio (NOW HIRING)

Confidential Healthcare Organization

A respected and growing healthcare organization is seeking an experienced Regional MDS Coordinator (RN) to provide leadership and oversight for multiple Skilled Nursing Facilities (SNFs) throughout the Cincinnati region.

This is a high-impact leadership opportunity for a Regional MDS Nurse with advanced expertise in MDS 3.0, RAI assessments, PDPM reimbursement, Medicare reimbursement, Medicaid reimbursement, clinical reimbursement, regulatory compliance, quality measures, and multi-facility operations.

Previous Regional MDS Coordinator experience overseeing multiple Skilled Nursing Facilities is required. Candidates with only facility-level MDS experience will not be considered.

As the Regional MDS Coordinator, you will provide operational and clinical leadership for MDS programs across multiple long-term care and skilled nursing facilities. The successful candidate will serve as the regional expert for MDS, RAI, PDPM, case mix management, clinical reimbursement, Medicare, Medicaid, and managed care reimbursement systems.

Responsibilities include:

• Overseeing MDS operations and reimbursement performance across multiple Skilled Nursing Facilities.

• Conducting routine facility audits to ensure compliance with CMS regulations, state regulations, and reimbursement requirements.

• Reviewing MDS assessments, care plans, clinical documentation, transmission reports, and reimbursement outcomes for accuracy and completeness.

• Monitoring and improving PDPM performance, case mix index (CMI), quality measures, Medicare reimbursement, Medicaid reimbursement, and revenue integrity.

• Serving as a resource and mentor to facility MDS Coordinators, RAI Coordinators, Directors of Nursing, and interdisciplinary care teams.

• Providing education and training related to MDS coding, documentation standards, reimbursement optimization, and regulatory compliance.

• Supporting survey readiness efforts and implementing corrective action plans when necessary.

• Analyzing reimbursement trends and developing strategies to improve clinical and financial performance.

• Partnering with facility leadership to enhance resident outcomes, quality measures, and operational success.

• Leading process improvement initiatives that strengthen clinical reimbursement programs throughout the region.

• Current and active Ohio Registered Nurse (RN) license required.

• Minimum of 5 years of MDS/RAI experience in Skilled Nursing Facilities or Long-Term Care.

• Mandatory: Prior experience as a Regional MDS Coordinator, Regional Clinical Reimbursement Consultant, Regional RAI Coordinator, or similar multi-facility MDS leadership role.

• Proven success managing MDS programs across multiple SNFs.

• Extensive knowledge of MDS 3.0, RAI Manual, PDPM, Medicare reimbursement, Medicaid reimbursement, managed care, quality measures, case mix systems, and CMS regulations.

• Strong understanding of clinical documentation improvement and reimbursement optimization strategies.

• Experience conducting MDS audits, compliance reviews, and reimbursement analysis.

• Long-Term Care and Skilled Nursing Facility experience required.

• AANAC certification strongly preferred.

• Exceptional leadership, communication, analytical, organizational, and coaching skills.

• Ability to travel regularly throughout the Cincinnati region.

• Competitive salary based on experience

• Mileage reimbursement

• Comprehensive medical, dental, and vision benefits

• Paid time off and holidays

• Retirement savings opportunities

• Professional development and continuing education support

• Opportunity to work with an experienced regional leadership team

• Long-term career growth within a stable and expanding healthcare organization

If you are a highly skilled Regional MDS Coordinator, Regional MDS Nurse, or Regional Clinical Reimbursement Consultant with demonstrated success in multi-facility SNF oversight, PDPM management, Medicare and Medicaid reimbursement, MDS auditing, case mix optimization, and regulatory compliance, we encourage you to apply for confidential consideration.

Only candidates with prior Regional MDS experience in Skilled Nursing Facilities will be considered.