Director of Facility-Based Clinical Reimbursement
Hillcrest Health & Living is seeking an experienced and strategic Director of Facility-Based Clinical Reimbursement (RN) to lead and oversee all reimbursement-related functions across our post-acute and long-term care communities. This individual will serve as a key resource for ensuring compliance, accuracy, and optimization of the MDS and PDPM processes, while supporting our mission of Inspiring people to live their best lives.
Key Responsibilities
- Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.
- Ensure accurate, timely completion and submission of MDS assessments in accordance with federal and state regulations.
- Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.
- Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer-specific reimbursement systems.
- Develop and implement policies and procedures to ensure consistent documentation and coding practices.
- Partner with clinical and financial leaders to align care documentation with reimbursement compliance.
- Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.
- Support education, training, and competency development for facility reimbursement teams.
- Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.
- Represent the reimbursement department in interdisciplinary and corporate-level meetings.
Qualifications
- Current Registered Nurse (RN) license in the state of Nebraska (or compact state).
- Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.
- Prior experience in post-acute care, long-term care, or skilled nursing facility management required.
- Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and clinical documentation requirements.
- Proven ability to lead, educate, and mentor multi-site clinical reimbursement teams.
- Excellent analytical, organizational, and communication skills.
- Ability to travel periodically between facilities.
Why Hillcrest
At Hillcrest, we believe in providing a career that helps you thrive—both professionally and personally. We offer:
- Comprehensive health, dental, and vision insurance options
- Paid time off
- Tuition reimbursement and student loan repayment for nurses
- Career growth and development opportunities
- A mission-driven culture centered on Integrity, Compassion, Respect, Teamwork, and Service
