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Pdpm Audit Jobs in Reston, VA (NOW HIRING)

Healthbridge Staffing

Corporate MDS Traveler

Fairfax, VA · Hybrid

$90K - $100K/yr

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

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 Sep 8, 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 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.

Director of MDS RN

Leesburg, VA • On-site

Loudoun Rehabilitation and Nursing Center
See more jobs at Loudoun Rehabilitation and Nursing Centerexternal

$49 - $52/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted yesterday

Job description

Loudoun Rehabilitation and Nursing Center is seeking an experienced Director of MDS (RN) to lead the clinical assessment and reimbursement process within our skilled nursing and rehabilitation facility.

This position plays a critical role in ensuring accurate assessments, regulatory compliance, strong interdisciplinary care planning, and optimized reimbursement under PDPM.

Key Responsibilities

  • Oversee completion, accuracy, and timeliness of all MDS assessments

  • Supervise and support one MDS nurse, providing guidance, auditing, and education

  • Ensure compliance with CMS, state, and federal regulations

  • Monitor PDPM case mix, clinical categories, and reimbursement accuracy

  • Lead and coordinate interdisciplinary care plan meetings

  • Conduct internal audits to ensure documentation supports coding and reimbursement

  • Educate nursing and IDT staff on documentation standards

  • Identify opportunities to improve case mix and reimbursement outcomes

  • Support survey readiness and participate during surveys and audits

  • Participate in QAPI and performance improvement initiatives

Qualifications

  • Active Virginia RN license or Compact license required

  • RAC-CT certification preferred

  • Minimum 1 year MDS experience in a skilled nursing setting

  • Strong knowledge of PDPM, CMS guidelines, and care planning regulations

  • Experience supervising or mentoring clinical staff preferred

  • Strong analytical, organizational, and communication skills

What We’re Looking For

We want someone who is:

  • Detail-driven and clinically strong

  • Confident in MDS coding and regulatory interpretation

  • Comfortable balancing hands-on work with light leadership

  • Proactive in identifying reimbursement and documentation opportunities

  • A collaborative partner to nursing, therapy, and billing teams

What We Offer

  • Competitive salary based on experience

  • Leadership role with direct impact on quality and reimbursement

  • Supportive leadership team

  • Health, dental, and vision benefits

  • Paid time off and holidays

  • 401(k)


Salary Range 90k - 110k depending on experience.

Ready to make a difference?
Apply today and join a team where your dedication is recognized and rewarded!

EEOC

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

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