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Azria Health is seeking an experienced and strategic Vice President of Clinical Reimbursement / MDS to lead reimbursement operations and clinical assessment processes across our skilled nursing and long-term care facilities throughout Iowa and Kansas. This executive leadership role is responsible for overseeing MDS operations, reimbursement optimization, regulatory compliance, clinical documentation integrity, and team development to ensure excellence in resident care and financial performance. The ideal candidate is a strong clinical leader with extensive knowledge of PDPM, Medicare and Medicaid reimbursement systems, MDS processes, and long-term care regulations. This individual will collaborate closely with regional and facility leadership teams to drive clinical and operational success.
Job Responsibility
Provide strategic oversight and leadership for all MDS and clinical reimbursement operations across multiple skilled nursing facilities
Ensure accuracy, timeliness, and compliance of MDS assessments and reimbursement processes
Lead and support regional and facility MDS coordinators and reimbursement teams
Monitor and optimize Medicare and Medicaid reimbursement performance under PDPM and state-specific reimbursement methodologies
Analyze reimbursement trends, case mix indices, quality measures, and financial outcomes to identify opportunities for improvement
Develop and implement policies, procedures, and best practices related to clinical reimbursement and MDS operations
Ensure compliance with all federal and state regulations, CMS guidelines, and company standards
Partner with clinical, operational, and financial leadership to improve documentation accuracy and reimbursement integrity
Conduct audits and provide education, training, and mentorship to facility teams
Assist facilities during surveys, audits, appeals, and regulatory reviews related to reimbursement and documentation
Stay current on regulatory changes, reimbursement updates, and industry best practices
Support acquisition onboarding, transitions, and operational initiatives as needed
Requirements
Active RN license required
multistate licensure preferred
Minimum of 5 years of experience in long-term care reimbursement and MDS leadership