What are the responsibilities and job description for the Director of Clinical Reimbursement position at Twin Rivers Health and Rehabilitation?
Twin Rivers Health and Rehabilitation is seeking a dedicated and experienced Director of Clinical Reimbursement to guide and direct reimbursement through PDPM, Case mix and clinical documentation via the MDS . The ideal candidate will possess a strong background in skilled nursing MDS management, multi facility reimbursement management, and have proven experience managing audits and ensuring documentation is appropriate to support billing diagnosis. This role requires a strategic thinker who can lead clinical teams, manage medical records, and develop comprehensive care plans while adhering to regulatory standards.
Twin Rivers Health and Rehabilitation is a skilled nursing management company based in Cleveland, TN. We operate facilities throughout Tennessee and are seeking someone for this position who is a proven leader in reimbursement management in a multi facility setting. Candidate does not need to live in Cleveland as we have multiple facilities around the state. You will manage a team of regional clinical reimbursement directors to maximize reimbursement at the facility level and ensure compliance with all state and federal guidelines, specifically the RAI manual.
Responsibilities
- Lead and manage clinical staff, providing guidance and support to ensure optimal patient care.
- Oversee the development and implementation of care plans tailored to individual patient needs.
- Conduct documentation reviews to ensure compliance with healthcare regulations and quality standards.
- Maintain accurate medical records and ensure proper documentation practices are followed.
- Collaborate with interdisciplinary teams to enhance patient outcomes and improve service delivery.
- Utilize knowledge of anatomy and physiology to inform clinical decisions and staff training.
- Ensure adherence to Medicare regulations and other relevant healthcare policies.
- Work efficiently to maximize reimbursement with therapy partners and other outside contractors.
Requirements
- Proven experience in a clinical leadership role, preferably as a Clinical Director of Reimbursement.
- Strong knowledge of critical care practices, medical records management, and home health systems.
- Excellent nurse management skills with the ability to motivate and lead diverse teams.
- Familiarity with developing care plans that align with best practices in patient care.
- In-depth understanding of anatomy, physiology, and relevant healthcare regulations (including Medicare).
- Exceptional organizational skills with attention to detail in documentation review processes.
- Strong communication skills, both verbal and written, for effective collaboration with staff and stakeholders.
- Registered Nurse
Job Type: Full-time
Pay: From $130,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: Hybrid remote in Cleveland, TN 37312
Salary : $130,000