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Pdpm Audit Jobs in Reston, VA (NOW HIRING)

Healthbridge Staffing

Corporate MDS Traveler

Fairfax, VA · Hybrid

$90K - $100K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Ensure compliance with state and federal regulations, Medicare requirements, PDPM, case-mix, and ... Support centers during staffing transitions, audits, or high census periods * Participate in ...

Montcare Potomac

MDS coordinator

Potomac, MD

$80K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Perform audits and quality assurance reviews related to MDS and care planning * Stay current with ... Experience with Medicare/Medicaid case mix and PDPM * Prior experience in a leadership or ...

All JobsPdpm Audit JobsPdpm Audit Jobs in Reston, VA

Pdpm Audit information

See Reston, VA salary details

$63.5K

$125.1K

$163.9K

How much do pdpm audit jobs pay per year?

As of Aug 18, 2026, the average yearly pay for pdpm audit in Reston, VA is $125,088.00, according to ZipRecruiter salary data. Most workers in this role earn between $108,200.00 and $142,000.00 per year, depending on experience, location, and employer.

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 Reston, VA?

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

What job categories do people searching Pdpm Audit jobs in Reston, VA look for?

The top searched job categories for Pdpm Audit jobs in Reston, VA are:

What cities near Reston, VA are hiring for Pdpm Audit jobs?

Cities near Reston, VA with the most Pdpm Audit job openings:

Pdpm Audit jobs near you
Infographic showing various Pdpm Audit job openings in Reston, VA as of August 2026, with employment types broken down into 1% Internship, 87% Full Time, 9% Part Time, 1% Temporary, and 2% Contract. Highlights an 86% Physical, 6% Hybrid, and 8% Remote job distribution, with an average salary of $125,088 per year, or $60.1 per hour.

Regional Director of Clinical Reimbursement

Medical Facilities of America, Inc.

Bethesda, MD • On-site

$96K - $131K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 8 days ago

Medical Facilities of America rating

6.5

Company rating: 6.5 out of 10

Based on 32 frontline employees who took The Breakroom Quiz

80th of 242 rated social care providers

Job description

) Medical Facilities of America, a regional leader in post-acute rehabilitation and skilled nursing services, is seeking a qualified Registered Nurse (RN) to join our team as a Regional Director of Clinical Reimbursement (MDS). This key position will oversee and support the MDS and clinical reimbursement processes across multiple skilled nursing and rehabilitation facilities within the Maryland region of the company. This position requires an RN license to practice Maryland.
In this role, you will ensure compliance, accuracy, and optimization of all Minimum Data Set (MDS) processes, driving both quality outcomes and financial integrity. You'll serve as a resource and mentor to facility MDS Coordinators and interdisciplinary teams, while leading initiatives that strengthen care delivery and reimbursement performance across the region.
What We Offer
  • Competitive compensation commensurate with experience.
  • Comprehensive health benefits (Medical, Dental, Vision)
  • 401(k), Flexible Spending Account, and additional elective benefits
  • Generous Paid Time Off (PTO)
  • Ongoing leadership development and career advancement opportunities

What You'll Do
  • Provide regional oversight and leadership to facility MDS and clinical reimbursement teams.
  • Ensure accurate and timely completion of MDS assessments in accordance with federal and state regulations.
  • Monitor and analyze case mix, PDPM categories, and reimbursement trends to optimize performance.
  • Conduct regular audits and provide feedback to maintain compliance and documentation integrity.
  • Develop and deliver training programs for facility MDS staff to strengthen clinical documentation and RAI process understanding.
  • Collaborate with Regional and Company Leadership to identify opportunities for improvement and implement strategic initiatives.
  • Partner with clinical and financial teams to ensure alignment between care delivery, documentation, and reimbursement outcomes.
  • Participate in Quality Assurance and Performance Improvement (QAPI) initiatives to promote excellence in resident care.

What You Need
  • Active, unencumbered licensure as a Registered Nurse (RN).
  • Proven experience in MDS coordination and clinical reimbursement.
  • Expert-level knowledge of MDS 3.0, PDPM, RAI process, and Medicare/Medicaid regulations.
  • Strong analytical, leadership, and communication skills.
  • Proven ability to train, mentor, and support interdisciplinary teams.
  • Proficiency with MDS software systems and Microsoft Office Suite (Word, Excel, etc.).
  • Willingness and ability to travel regionally to assigned facilities.

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