Clinical Reimbursement Partner SNF

Clinical Reimbursement Partner - SNF

About Us:

Ecumen is an industry leader dedicated to advocating for older adults by providing housing choices, compassionate healthcare, and innovative services. For 160 years Ecumen has cared for those in need. Now, as Minnesota's 8th largest senior living provider, we continue to advocate for those we serve. Join a team where you can make a difference in advancing our mission to serve our older adults, while we commit to creating a place where everyone belongs.

Pay: The targeted pay range for this job is $110,000 - $115,000 annually. Ecumen considers a variety of factors when determining new hire pay including experience, qualifications, and, when applicable, certifications, licenses, and education.

Benefits: Ecumen offers a comprehensive benefits package to our full-time team members including medical, dental, vision, flexible spending and health savings accounts, life & disability insurance, paid holidays, flexible time off, a generous 6% 401(k) match, and other well-being resources. Learn more at https://www.ecumen.org/find-a-career/benefits/. You'll also enjoy the convenience and flexibility of working remote.

The Clinical Reimbursement Partner - SNF is responsible for optimizing reimbursement from all SNF payer sources, conducting multi-site revenue analyses, and synthesizing corporate data. This position is responsible for maximizing MDS FTE and cross-coverage, mitigating/preventing takebacks, and improving organizational processes. This position is also responsible for identifying gaps in MDS accuracy, targeting Quality Measure improvements, and providing education to enhance MDS workflows and organizational knowledge.

Essential Job Responsibilities:

1. Leads clinical reimbursement practices for Skilled Nursing Facilities through oversight of MDS practices across the organization.
2. Ensures that MDS clinical processes meet all applicable regulatory requirements and industry best practices.
3. Develops and recommends process flows for SNF that enhance efficiency and maximize reimbursement potential.
4. Provides ongoing education, orientation, and resources to MDS coordinators and acts as the subject matter expert on technical MDS processes.
5. Responsible for overseeing MDS functions across the organization to ensure standardized, optimized MDS coding to maximize SNF reimbursement, maintain regulatory compliance and decrease organizational risk.
6. Conducts and supervises MDS documentation audits to ensure accuracy, compliance, and alignment with current RAI practices.
7. Provides back-up support to MDS coordinators across the organization.

Clinical Reimbursement Partner - SNF Minimum Required Qualifications:

• Bachelor's degree in nursing
• Minimum of 3-5 years of experience in healthcare, clinical quality and reimbursement, and healthcare compliance.
• Minimum of 2-3 years of experience in MDS coordination/RAI process or a similar role.
• Must be licensed as a Registered Nurse within the state in which working and must maintain licensure Practical experience with relevant clinical systems.
• Strong knowledge of Medicare regulations and reimbursement methodologies
• Ability to communicate effectively in both verbal and written formats
• Proficient with Microsoft Office Suite
• Able to follow all safety rules, regulations, policies and procedures of the facility including but not limited to: Vulnerable Adult and Abuse Policy, HIPAA, Resident's Bill of Rights, Universal Precaution, AWAIR, OSHA, Right to know, SDS, ADA, HUD Policy and Procedures, Fair Housing laws and regulations

Preferred Qualifications:

• Master's Degree in Nursing or related fields
• RAC-CT or RAC-CTA
• Experience in conducting clinical audits and implementing quality improvement initiatives