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Saint Albans

    Regional Clinical Reimbursement Manager - St Albans, United States - Mission Health Communities

    Mission Health Communities
    Mission Health Communities St Albans, United States

    Found in: Lensa US 4 C2 - 5 days ago

    Default job background
    Description


    T ogether, our Resident Core Values and Team Core Values define Mission Health's commitment to the principals of Wellness and Enrichment.

    We believe our focus on the overall wellness of our residents and our commitment to enriching their lives makes us different from others in our industry.

    We are actively looking for a Regional Clinical Reimbursement Manager who can easily travel to GA and TN.


    Under the direction of the Director of Clinical Reimbursement responsible to oversee appropriate reimbursement for all PPS, Case Mix and MDS for the Region.

    Responsible for providing assistance and education to Facility Clinical Reimbursement Coordinators related to the MDS process and MDS software functionality.

    This position will work with the clinical team to help ensure compliance with all state and federal guidelines, and will monitor and report any processing deficiencies as needed.

    This position will supervise Facility Clinical Reimbursement Coordinators.


    Essential Functions:
    ·

    Overseeandmonitorall PPS,CaseMixandMDSactivityforthe District.

    ·

    ServeastheprimaryresourcepersontothefacilityClinicalReimbursementCoordinatorsrelatedtothe MDS and Company processes.

    ·

    ProvideorientationrelatedtotheMDSandCompanyprocessestonewemployeesandprovideongoing training as needed.

    ·

    MonitorMedicaidandMedicareperformanceindicatorsandinitiateappropriateandtimelyactiontocorrect deficient practices and improve exception performance areas.

    ·

    Coordinatewiththeclinicalteamtoensurecompliancewithallstateandfederal guidelines.

    ·

    ProvidetrainingofallMDSSoftwareupdates,bothcompanyinitiatedaswellasstateandfederal reimbursement systems.

    ·

    Advisesupervisorandappropriatedepartmentsofsoftwaresupportitemsthatrequireprogramadaptationsor

    enhancements.

    ·

    SupervisefacilityClinicalReimbursementCoordinators positions.

    ·

    Superviseworkthroughtheplanningandschedulingofworkassignmentsandthereviewandapprovalof

    tasks.

    ·

    Superviseworkassignmentsandperformancedevelopment (appraisal).

    ·

    Supervise/manage/directtheselection,training,development,andappraisalof personnel.

    ·

    Participateinproactiveteameffortstoachievedepartmentalandcompany goals.

    ·

    Provideleadershiptoothersthroughexampleandsharingof knowledge/skills.

    ·

    MaintainexpertworkingknowledgeoftheMDS/RAI process.

    ·

    Traveltofacilitiesasneededtoevaluatefacilityproductionandtrainfacility

    staff.

    ·

    ReviewfacilityprocessingandadviseExecutiveDirector,RegionalTeam,andCorpDirectorofabnormal

    trends.

    ·

    Prepareandsubmitreportsonfacilityoperations,as required.

    ·

    Attendand/orconductmeetings,asrequired,tocarryout responsibilities.

    ·

    Ensureadequatepreparationfor,andparticipateinregulatorycompliancesurveysas

    needed.

    ·

    Muststayincompliancewithallstate,federal,andgovernmentagencies.
    Reportallunsafeactivitiesto supervisor and/or Human Resources.

    ·

    Demonstraterespectandcompassioninevery interaction.

    ·

    Conductoneselfwiththehighestdegreeofhonesty andintegrityinevery interaction.

    ·

    Demonstrateapassionforcaringasevidencedbyinteractionwithco-workers,residents,families,and

    visitors.

    ·

    Perform otherdutiesas assigned.

    Position Qualifications

    Education


    • Must possessavalidlicenseasaRegisteredNurse.
    Completionofanapprovedcourseof nursing study.

    Experience

    Musthaveextensiveworkingknowledgeinthefollowing:
    thePPSprocess,MDScompletionprocess,MDS Program and it functionality in the long term care environment.

    The position will be 50% travel throughout the Region.

    Ideally someone in the Atlanta market or within a commutable distance to Atlanta airport would be ideal as the position would travel to facilities in GA and TN.

    COMPENSATION & BENEFITS

    We are committed to offering a competitive wage and a comprehensive benefits package.

    Some of the benefits available include:

    Highly competitive compensation plus bonus


    Medical/Dental/Vision Coverage


    Short Term/Long Term Disability


    Flexible Spending Accounts


    Life Insurance


    401k Savings Plan


    CEU Reimbursement


    Capella University / Sophia Learning


    Paid Time Off

    Mission Health Communities is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sex, national origin or disability. Pre-employment criminal background screening and drug test are required.

    #J-18808-Ljbffr

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