Director, Denials and Appeals Management- Skilled Nursing experience ONLY

SnF Management Company - Sacramento, CA

Full-time

Are you concerned about PDPM this October and the impact on your job? Call us regarding a new position.

SnF Management is currently accepting applications for a Dynamic and Driven candidate with experience in denial/appeals claims management in a skilled nursing setting.

The ideal candidate is an MDS Nurse with rehab background and appeals background.

We are seeking someone that is driven, results oriented, and possesses superb interpersonal skills. This position is responsible for the overall clinical denials management process in the 38 locations throughout California and Arizona.

Duties include but are not limited to:

  • Evaluate all processes to ensure efficiency as well as developing and implementing new processes to meet organizational needs
  • Develop and manage initiatives to ensure operations of the denials/appeals management team is in line with organizational goals
  • Interpret and implement complex rules and regulations governing insurance, appeals activities, trends, etc. to make recommendations
  • Maintain a good working relationship with all facilities, rehabilitation providers and ensure clear communication
  • Interact with all interdisciplinary team members, corporate team members, and rehabilitation providers while maintaining a standard of professionalism

Qualifications:

  • MDS Nurse with valid CA nursing license
  • 1-3 years of progressive experience in denial/appeals claim management in a skilled nursing environment
  • 1-3 years management experience preferred
  • Excellent communication and interpersonal skills
  • Strong analytical skills required
  • Advanced computer skills required
  • Bachelor’s degree preferred
  • Ability to travel day and evening with overnight stays with California and Arizona (50 to 60%)

Job Type: Full-time

Benefits offered:

  • Paid time off
  • Health insurance
  • Dental insurance
  • Retirement benefits or accounts
  • Education assistance or tuition reimbursement
  • Employee discounts