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Pdpm Audit Jobs in Wisconsin (NOW HIRING)

Eden Senior Care

MDS Coordinator

Oshkosh, WI · On-site

$80K - $90K/yr

Run Utilization Review Meetings and ensure PDPM scores and rates are validated * Review and Educate ... Chart Reviews/Audits as needed * Assist IDT during Survey process Qualifications: * Must hold an ...

Outagamie County, WI

MDS Coordinator (BV)

Appleton, WI · On-site

$80K - $90K/yr

The MDS Coordinator serves as the expert resource for the Patient-Driven Payment Model (PDPM) and ... Audit and improve staff education/competency as needed to ensure accurate and timely completion of ...

Outagamie County, WI

MDS Coordinator (BV)

Appleton, WI · On-site

$80K - $90K/yr

The MDS Coordinator serves as the expert resource for the Patient-Driven Payment Model (PDPM) and ... Audit and improve staff education/competency as needed to ensure accurate and timely completion of ...

GovernmentJobs.com

MDS Coordinator (BV)

Appleton, WI · On-site

$32.50 - $41.75/hr

The MDS Coordinator serves as the expert resource for the Patient-Driven Payment Model (PDPM) and ... Audit and improve staff education/competency as needed to ensure accurate and timely completion of ...

Outagamie County

MDS Coordinator (BV)

Appleton, WI · On-site

$80K - $90K/yr

The MDS Coordinator serves as the expert resource for the Patient-Driven Payment Model (PDPM) and ... Audit and improve staff education/competency as needed to ensure accurate and timely completion of ...

All JobsPdpm Audit JobsPdpm Audit Jobs in Wisconsin

Pdpm Audit information

What is a PDPM audit?

A PDPM audit is an evaluation process that reviews how a skilled nursing facility implements the Patient-Driven Payment Model (PDPM). Auditors examine clinical documentation, coding, and billing practices to ensure compliance with Medicare regulations and to verify that residents are being accurately assessed and classified for payment. The goal is to identify errors or discrepancies that could lead to improper payments or regulatory issues, and to help facilities improve their processes for accurate reimbursement. Regular PDPM audits can help facilities avoid penalties and maintain financial stability.

What are the key skills and qualifications needed to thrive as a PDPM auditor?

To thrive as a PDPM Auditor, you need a solid understanding of Medicare reimbursement systems, MDS (Minimum Data Set) assessments, and skilled nursing facility regulations, typically supported by clinical credentials such as RN, LPN, or certification in MDS/RAI. Familiarity with electronic health record (EHR) systems, PDPM calculation software, and audit tools is essential. Strong analytical thinking, attention to detail, and effective communication skills help ensure accuracy and clarity when reviewing records and providing feedback. These skills are vital to optimize reimbursement, maintain regulatory compliance, and support quality patient care.

What are some common challenges faced by professionals conducting PDPM audits in skilled nursing facilities?

Professionals performing PDPM (Patient-Driven Payment Model) audits often encounter challenges such as ensuring accurate clinical documentation, keeping up with frequent regulatory changes, and effectively communicating findings to interdisciplinary teams. They must carefully review MDS assessments, therapy documentation, and nursing notes to verify compliance and reimbursement accuracy. Additionally, working collaboratively with clinical and administrative staff is crucial for implementing corrective actions and maintaining ongoing compliance.

What is the difference between Pdpm Audit vs Pdpm Compliance Officer?

AspectPdpm AuditPdpm Compliance Officer
Primary RoleConducts audits to ensure adherence to Pdpm standards and regulationsEnsures organizational compliance with Pdpm policies and external regulations
CertificationsOften requires auditing or quality assurance certificationsRequires compliance or regulatory certifications
Work EnvironmentAuditing in various departments, often in a review or assessment capacityMonitoring and implementing compliance measures across the organization
Industry UsageCommon in healthcare, manufacturing, and service sectorsPrevalent in healthcare, finance, and regulated industries

While both roles focus on adherence to Pdpm standards, Pdpm Audits primarily evaluate compliance through assessments, whereas Pdpm Compliance Officers develop and oversee compliance programs to ensure ongoing adherence.

What are popular job titles related to Pdpm Audit jobs in Wisconsin?

For Pdpm Audit jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Pdpm Audit jobs in Wisconsin look for?

The top searched job categories for Pdpm Audit jobs in Wisconsin are:

What cities in Wisconsin are hiring for Pdpm Audit jobs?

Cities in Wisconsin with the most Pdpm Audit job openings:

Pdpm Audit jobs near you
Infographic showing various Pdpm Audit job openings in Wisconsin as of August 2026, with employment types broken down into 90% Full Time, 5% Part Time, 1% Temporary, and 4% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution.

Regional MDS Coordinator (RN)

Skilled Healthcare Center

Milwaukee, WI • On-site

$110K - $140K/yr

Full-time

Re-posted 22 days ago

Job description

The Regional MDS Coordinator (RN) provides oversight, guidance, and clinical support to multiple Skilled Nursing Facilities to ensure accurate, timely, and compliant completion of the Minimum Data Set (MDS) in accordance with CMS, state, and company standards. This role focuses on regulatory compliance, reimbursement optimization, staff education, and quality outcomes across assigned facilities.

Qualifications (Required)

  • Active Registered Nurse (RN) license in good standing (multi-state preferred if applicable)

  • Minimum 3–5 years of MDS experience in a Skilled Nursing Facility

  • Demonstrated expertise in RAI process, PDPM, and CMS regulations

  • Previous experience as an MDS Coordinator required

  • Ability to travel between assigned facilities

  • Strong analytical, organizational, and communication skills

Preferred Qualifications

  • Regional or multi-facility MDS oversight experience

  • RAC-CT or RAC-CTA certification

  • Experience with EHR systems (PointClickCare or similar)

  • Prior survey management or audit experience

Essential Duties & ResponsibilitiesRegional Oversight

  • Provide clinical and operational oversight of MDS processes across assigned SNFs

  • Ensure accurate, timely completion of all MDS assessments in compliance with CMS and state regulations

  • Monitor PDPM classification accuracy and reimbursement integrity

Compliance & Auditing

  • Conduct routine audits of MDS assessments, care plans, and supporting documentation

  • Identify risk areas related to reimbursement, quality measures, and surveys

  • Collaborate with facility leadership to implement corrective action plans

Education & Support

  • Train and mentor facility MDS Coordinators and interdisciplinary team members

  • Provide ongoing education related to RAI updates, PDPM changes, and regulatory guidance

  • Serve as a clinical resource for complex cases and assessment questions

Quality & Performance

  • Monitor quality measures, Five-Star ratings, and survey outcomes related to MDS

  • Support facilities in improving clinical documentation and care planning

  • Participate in performance improvement initiatives

Collaboration & Reporting

  • Work closely with DONs, Administrators, Therapy teams, and Corporate leadership

  • Prepare and present reports on compliance, reimbursement trends, and performance metrics

  • Assist with survey preparation and post-survey follow-up as needed

Physical & Travel Requirements

  • Ability to travel regionally (percentage as defined by employer)

  • Ability to sit, stand, and use a computer for extended periods