• Director of Clinical Reimbursement

    Job ID
    2018-12476
    Category
    Nursing Leadership
    Job Location : City
    Roseville
    Job Location : State
    MN
    Campus
    PHS Management LLC
    Type
    Full Time
  • Overview

    Presbyterian Homes & Services is seeking a Director of Clinical Reimbursement to join our RAI/MDS team.  This position is based out of our Corporate Home Office in Roseville, MN and supports all our sites throughout MN, IA, and WI.  

     

    The Director of Clinical Reimbursement is responsible for the oversight of clinical reimbursement aspects of Presbyterian Homes’. This position oversees the corporate shared services RAI/MDS function.

     

    REPORTING STRUCTURE
    The Director of Clinical Reimbursement reports to the Senior Director of Clinical Services.

    The Director of Clinical Reimbursement works collaboratively with PHS Management staff, Campus/Care Center Administrators, Clinical Administrators, Health Information staff, clinical staff within facilities, outside agencies and functional directors of assigned areas of accountability.

     

    Responsibilities

    Some of the responsibilities of this position are:

    • Ensure consistent and continuous compliance by maintaining awareness of both Federal and State
      (MN, WI, IA) regulations and reimbursement practices.
    • Promote efficient and effective operations by providing expert clinical reimbursement oversight for
      PHS skilled Care Centers. Assist in the recruitment and hiring of RAI Directors and MDS Nurses, and
      act as a resource for staff when questions arise.
    • Participate in the development and analysis of KRA’s, Community Action Plans, and progress toward goals. 
    • Oversee and lead the RAI process.  Direct and ensure the development and completion of the resident assessment process with other health professionals consistent with regulations and established clinical best practices. Ensure timely, accurate and complete assessment of the resident’s health and functional status during the entire assessment period.  
    • Lead the RAI/MDS program and staff to ensure an environment that achieves high quality care and service for residents (physical, mental, emotional, social and spiritual) and maintains their independence and dignity to the highest degree possible. Establish and maintain effective communication systems with all customers. 
    • Function as an RAI/MDS nurse and Clinical Reimbursement resource to the staff, backfilling the RAI Director role during a transition period as needed.   Conduct site specific education at assigned care centers.  

    Qualifications

    1. Degree in Nursing required with current licensure from the State Board of Nursing in states which he/she practices.
    2. 2+ years experience with RAI process/MDS completion, reimbursement, clinical resource utilization and/or case management.
    3.  High initiative and ability to efficiently and effectively lead interdisciplinary teams and coordinate and manage RAI process.
    4.  Demonstrated ability to write and implement policies and procedures.
    5. Demonstrated computer proficiency in Microsoft Office applications and electronic medical records.
    6. Knowledge of State and Federal regulatory requirements for long-term care. Working knowledge of regulatory compliance. Working knowledge of reimbursement systems for long-term care.
    7. Excellent written, interpersonal, and communication skills; adaptability, flexibility, and creativity. Ability to communicate with a variety of people.
    8. Demonstrated ability to read, write, speak and understand the English language to communicate with all customers.
    9. Demonstrated compatibility with PHS's mission and operating philosophies.

    About PHS

    Presbyterian Homes & Services (PHS), based in St. Paul, Minnesota, is a non-profit, faith-based organization providing a broad array of high quality housing choices, care and service options for older adults. 6,400 employees serve 25,000 older adults through 45 PHS-affiliated senior living communities in Minnesota, Wisconsin and Iowa, and through Optage® home and community services. Established in 1955, PHS has earned the reputation as an innovative leader concerned with promoting independence, vitality and well-being for those they serve.


    We believe employees are the most important resource in our ministry and we are committed to an environment where employees are valued and empowered to make a difference. With a strong commitment to grow our employees from within, the development opportunities with us are virtually unlimited. We offer competitive wages, opportunities for advancement, ongoing training, and incredible benefits like education assistance and nursing loan forgiveness.


    If you have a desire to honor God by enriching the lives and touching the hearts of older adults, consider answering the call and join our team.

     

     

     


    PHS is an EEO/AA employer. All applicants will receive consideration for employment regardless of their race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status, or status with regard to public assistance.

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