Vice President of Clinical Reimbursement

At SLP Operations, LLC, we believe everyone deserves a great life, including you. Our commitment is to provide love, attention, and optimal care one resident at a time. We realize consistently fulfilling this commitment depends on the success of caring professionals like you, who build their careers with us. Together, we are setting the standard in the delivery of rehabilitation, quality post-acute services and long-term care.

Now more than ever, your skills and dedication can make a difference for those who need it most. Come make a difference with us!

Advantages We Offer

• Medical, vision and dental insurance
• Employer-paid life insurance
• Paid time off
• Paid holidays
• Flexible schedules
• Long term growth and advancement opportunities

JOB SUMMARY: The Vice President of Clinical Reimbursement is responsible for leading the reimbursement team and overseeing the accurate and timely completion of all Medicare/Medicaid case-mix documents to assure appropriate reimbursement for care and services provided within the skilled nursing facilities. Conducts continual Minimum Data Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG) category. Oversees the overall process and tracking of MDS/Prospective Payment System (PPS) documentation and submission.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Oversee the functions and operations of the Clinical Reimbursement team.
• Ensures that the facilities are in compliance with the organization’s policy and procedures and comply with all required state regulations.
• Ensures the accurate and timely completion of all MDS Assessments including PPS Medicare, quarterly, annual, and communicates any significant changes.
• Participates in care conferences as needed or requested by the facility for educational and consulting purposes.
• Oversees comprehensive assessment of potential residents.
• Provides clinical reimbursement training to staff.
• Verifies electronic submissions of MDS, performs corrections when necessary, and maintains appropriate records.
• Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal and state standards.
• Schedules and conducts resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews before resident care conferences.
• Assists disciplines in formulating and revising care plans. Ensures that resident’s present/potential problems are identified and prioritized; realistic goals are established, and nursing intervention is appropriate.
• Evaluates resident care plans for comprehensiveness and individuality.
• Assesses the achievement or lack of achievement of desired outcomes. Ensures that the resident’s care plan is reassessed and revised appropriately.
• Responsible for all levels of care changes within the facility. Notifies all departments when a level of care change has been made.
• He/she will integrate nursing, dietary, social recreation, restorative, rehabilitation, and physician services to ensure appropriate assessment and reimbursement requirements are met.
• Generates appropriate forms to complete the level of acuity and changes. Transmits forms to the appropriate agency for processing as required by state law.

Qualifications

• Bachelor’s degree in nursing required.
• Five years of management experience with experience in long-term care
• Must possess a current, unencumbered, active license to practice as an RN in the state.
• General knowledge of professional basic nursing, restoratives, and personal care services

Equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.