Top 453 Reimbursement manager Jobs in Friant Ca

Director of Patient Care Services (DPCS)-RN
Kure Home Health —Fresno, CA
- $120,000 - $140,000 a year
- Full-time
- Nursing
- RN License
- 3 years
- Relocation assistance
- Health insurance
Quick Apply
Manager of Clinical Practice & Nursing Development
Community Health System —Fresno, CA
- $77.72 - $98.90 an hour
- 8 hour shift
- Nursing
- Management
- RN License
- Free parking
- 403(b) matching
Territory Sales Manager
PartsXpress —California
- $50,000 - $70,000 a year
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Travel reimbursement
- Mileage reimbursement
Quick Apply
Travel Physical Therapist (PT) Inpatient Rehab- up to $2,500/wk including San Diego, CA
Gold Coast Healthcare Staffing LLC —California
- $2,400 - $2,600 a week
- Full-time
- CPR Certification
- Hospital
- Physical & Rehabilitation Medicine
- Travel reimbursement
- Continuing education credits
Quick Apply
RN Manager, Cardiac Procedural Services
Community Health System —Fresno, CA
- $82.38 - $104.83 a day
- 8 hour shift
- RN License
- Hospital
- BLS Certification
- Free parking
- 403(b) matching
Physical Therapist 2, Oncology, Outpatient
Community Health System —Clovis, CA
- $56.22 - $71.54 an hour
- 8 hour shift
- BLS Certification
- Physical & Rehabilitation Medicine
- Mid-level
- Free parking
- 403(b) matching
Physical Therapist 2, Oncology, Outpatient
Community Health System —Clovis, CA
- $56.22 - $71.54 an hour
- 8 hour shift
- BLS Certification
- Physical & Rehabilitation Medicine
- Mid-level
- Free parking
- 403(b) matching
PT, Inpatient Rehab
Community Health System —Fresno, CA
- $53.80 - $68.46 an hour
- 8 hour shift
- BLS Certification
- Physical & Rehabilitation Medicine
- Inpatient
- Free parking
- 403(b) matching
Territory Manager, San Jose
Ria Money Transfer (Dandelion) —California
- $50,000 - $60,000 a year
- Weekends as needed
- Remote
- Spanish
- English
- Mid-level
- Mileage reimbursement
- Employee stock purchase plan
Quick Apply
Center Account Manager, Northwest (Cystic Fibrosis)
Vertex Pharmaceuticals —California
- $136,000 - $204,000 a year
- Weekends as needed
- Up to 50% travel
- Hospital
- 5 years
- Loan repayment program
- Dental insurance
Territory Sales Manager - Building Products
The Hiring Method, LLC —California
- Business development
- Driver's License
- Travel
- Health insurance
- Dental insurance
Quick Apply
9d
Specialty Business Manager, Derm - Walnut Creek - San Jose, CA
Takeda Pharmaceutical —California
- $63.51 - $87.31 an hour
- Full-time
- Remote
- Private practice
- Hospital
- Bachelor of Science
- Paid holidays
- Disability insurance
10d
RN Case Manager
Community Health System —Fresno, CA
- $53.09 - $67.56 an hour
- Full-time
- Nursing
- RN License
- Hospital
- Free parking
- 403(b) matching
Specialty Business Manager, Derm - Palo Alto, CA
Takeda Pharmaceutical —California
- $63.51 - $87.31 an hour
- Full-time
- Remote
- Private practice
- Hospital
- Bachelor of Science
- Paid holidays
- Disability insurance
10d
Housing Specialist
Liberty Healthcare Corporation —Fresno, CA
- $35 an hour
- Multiple hires
- Research
- Mid-level
- Travel
- Travel reimbursement
- Cell phone reimbursement
Quick Apply
Sr. Operations Manager
Amazon.com Services LLC —Fresno, CA
- $135,000 - $182,700 a year
- Full-time
- Management
- Construction site
- Customer service
- AD&D insurance
- Health insurance
Payroll Clerk
Costco Wholesale Corporation —Clovis, CA
- Office
- Driving
- US work authorization
- AD&D insurance
- Employee stock purchase plan
Operations Manager
Amazon.com Services LLC —Fresno, CA
- $91,000 - $136,500 a year
- Weekends as needed
- Mid-level
- Ability to climb stairs
- Bachelor's degree
- AD&D insurance
- Health insurance
7d
Inventory Auditor
Costco Wholesale Corporation —Clovis, CA
- Research
- Mid-level
- Driving
- AD&D insurance
- Employee stock purchase plan
Housing Case Manager
Valley Teen Ranch —Fresno, CA
- Part-time
- Background check
- Ability to walk for extended periods
- Mid-level
Quick Apply

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Director of Patient Care Services (DPCS)-RN

Kure Home Health
Fresno, CA

Quick Apply

Job Details

Full-time
$120,000 - $140,000 a year

Benefits

Relocation assistance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Home care experience
Nursing
Medicare
RN License
Quality of care (regulatory compliance area)
Team leadership
CMS regulatory compliance
Supervising experience
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Bachelor of Science in Nursing
QA/QC
Data interpretation
Bachelor's degree in nursing
Home health
Home healthcare regulations
IV Certification
Home health agency experience
Project leadership
Nursing
Quality assurance experience within healthcare

Full Job Description

Clinical Director / Director of Patient Care Services (DPCS)

Reports To

CEO / Administrator

Position Summary

The Clinical Director / Director of Patient Care Services (DPCS) is responsible for the overall clinical compliance, regulatory oversight, quality management, and operational leadership of the agency’s home health services. This position ensures full compliance with Medicare Conditions of Participation (CoPs), California state regulations, and ACHC standards.

The Clinical Director serves as the designated Clinical Manager under Medicare CoPs and maintains final clinical oversight authority over patient care delivery, documentation integrity, OASIS accuracy, QAPI activities, survey readiness, ADR management, and staff clinical performance.

This is a leadership position requiring consistent availability to ensure patient continuity of care, regulatory compliance, staff support, and immediate response to emergent clinical situations.

Authority & Accountability

Final clinical oversight of all patient care services
Clinical decision-making and plan of care compliance
Admissions approval or denial based on clinical appropriateness
Implementation of corrective action plans
Enforcement of documentation standards and productivity expectations
Oversight of OASIS accuracy and submission integrity
Investigation of clinical incidents and quality concerns
Clinical staffing oversight and patient assignment decisions
QAPI implementation and performance improvement initiatives
Ownership of all Additional Documentation Requests (ADRs)
Regulatory readiness and survey preparation activities
Maintains full ownership and accountability for all ADRs
Clinical Compliance & Oversight
Oversees all direct and indirect clinical services provided by the agency.
Ensures compliance with Medicare Conditions of Participation and California regulations.
Functions as Clinical Manager as defined under Medicare CoPs.
Ensures individualized Plans of Care are developed, implemented, and updated appropriately.
Oversees clinical documentation timeliness, accuracy, and regulatory compliance.
Conducts clinical record reviews and audits.
Ensures appropriate clinical staffing and patient assignment oversight.
Serves as the primary clinical escalation resource for field staff, physicians, hospitals, referral sources, and community partners.

OASIS & Documentation Integrity

Oversees OASIS assessment accuracy, validation, correction processes, and submission integrity.
Reviews OASIS scoring trends and outcomes data.
Monitors OASIS outcomes and develops corrective action plans as needed.
Ensures documentation supports medical necessity and reimbursement compliance (PDGM).
Monitors timely chart completion and EMR compliance.
Addresses clinician documentation deficiencies and ensures corrective action when indicated.

ADR & Audit Management

Oversees all ADR activity, including document collection, chart review, submission tracking, and timely response to payer requests.
Maintains an ADR tracking system and ensures all requests are completed and submitted within required deadlines.
Collaborates with clinicians, medical records, physicians, referral sources, and leadership to obtain required documentation and resolve ADR deficiencies.
Monitors ADR outcomes and trends and implements corrective action plans when deficiencies are identified.
Escalates barriers that may impact compliance or submission deadlines.

Physician Orders & Documentation Management

Oversees timely processing, tracking, and physician signature compliance for all orders, plans of care, and supplemental physician documentation.
Monitors outstanding unsigned orders and implements corrective action plans to maintain regulatory compliance.

QAPI & Performance Improvement

Leads and oversees the agency’s QAPI program.
Reviews hospitalizations, infections, falls, incidents, complaints, grievances, missed visits, and patient satisfaction data.
Reviews agency KPIs including patient satisfaction, rehospitalization rates, documentation timeliness, productivity, incident trends, and quality outcomes.
Develops and implements corrective action plans.
Prepares quality reports and ensures survey readiness at all times.
Reports quality outcomes and performance improvement initiatives to leadership.

Labor Distribution & Productivity Oversight

Monitors clinician productivity and visit utilization.
Reviews overtime trends and staffing efficiency.
Adjusts staffing oversight based on census fluctuations.
Partners with leadership on clinical budget management.
Participates in workforce planning to support census growth and patient care needs.

On-Call & Availability Requirements

Serves in the agency’s on-call rotation as assigned.
Must remain accessible to clinical staff, physicians, referral sources, patients, and leadership.
Responds promptly to emergent clinical situations, urgent patient concerns, hospitalizations, after-hours escalations, and staff questions.
Provides clinical decision-making and administrative oversight during on-call coverage.
Ensures continuity of clinical leadership coverage during absences and scheduled time off.
Inconsistent accessibility may be subject to performance review.

Risk Management & Patient Safety

Oversees investigation, documentation, and follow-up of adverse events and incidents.
Monitors infection control compliance.
Reviews rehospitalization trends.
Oversees investigation and resolution of patient, family, referral source, and employee complaints and grievances.
Ensures corrective actions are documented, implemented, and tracked for effectiveness.

Regulatory Readiness

Maintains agency survey readiness at all times.
Ensures compliance with ACHC standards.
Oversees clinical record retention requirements.
Conducts routine compliance reviews and mock survey activities.
Communicates regulatory updates to staff and ensures implementation of required changes.

Staff Supervision & Development

Hires, supervises, evaluates, disciplines, and terminates clinical personnel.
Conducts annual and as-needed performance evaluations.
Completes employee evaluations within required timeframes.
Oversees orientation and competency validation.
Ensures annual competencies, skills validations, and required clinical education are completed and documented.
Implements in-service and regulatory training updates.
Provides coaching, mentoring, competency validation, and corrective action as needed.

Leadership Accountability

Maintains ownership of assigned projects, initiatives, deadlines, and regulatory deliverables.
Proactively communicates barriers, delays, and operational concerns with recommended solutions.
Ensures assigned responsibilities are completed within established deadlines or escalated appropriately when assistance is needed.
Maintains confidentiality of patient, employee, leadership, financial, and operational information.
Demonstrates professionalism, accountability, sound judgment, and ethical leadership conduct.

Position Qualifications

Current Registered Nurse (RN) license in California (required) or licensed physician in California.
BSN required; Master’s degree preferred.
Minimum three (3) years management experience in home health.
Strong knowledge of Medicare CoPs, ACHC standards, OASIS, PDGM, ADRs, and California regulations.
Demonstrated experience leading QAPI and compliance programs.
Strong leadership, regulatory interpretation, decision-making, communication, and organizational skills.

Disclosure

Duties and responsibilities may be adjusted at the discretion of the Company to meet regulatory requirements, operational demands, and the best interests of the organization.

Job Type: Full-time

Pay: $120,000.00 - $140,000.00 per year

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Relocation assistance
Vision insurance

Medical Specialty:

Geriatrics
Home Health
Medical-Surgical
Wound Care

Ability to Relocate:

Fresno, CA 93793: Relocate before starting work (Required)

Work Location: In person

Quick Apply

Refine Your Search

reimbursement manager jobs in friant ca

Director of Patient Care Services (DPCS)-RN

Manager of Clinical Practice & Nursing Development

Territory Sales Manager

Travel Physical Therapist (PT) Inpatient Rehab- up to $2,500/wk including San Diego, CA

RN Manager, Cardiac Procedural Services

Physical Therapist 2, Oncology, Outpatient

Physical Therapist 2, Oncology, Outpatient

PT, Inpatient Rehab

Territory Manager, San Jose

Center Account Manager, Northwest (Cystic Fibrosis)

Territory Sales Manager - Building Products

Specialty Business Manager, Derm - Walnut Creek - San Jose, CA

RN Case Manager

Specialty Business Manager, Derm - Palo Alto, CA

Housing Specialist

Sr. Operations Manager

Payroll Clerk

Operations Manager

Inventory Auditor

Housing Case Manager

I want to receive the latest job alert for reimbursement manager in friant ca

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