Senior Director of Clinical Reimbursement Operations

OverviewMDS Solutions, a division of Key Rehabilitation, is looking for fun, energetic, and self-driven team members to join our remote MDS division as a Senior Director of Clinical Reimbursement Operations.The Senior Director of Clinical Reimbursement Operations (SDCRO) oversees MDS Coordinators and manages financial operations within MDS Solutions. The SDCRO handles MDS coordination, client relations related to RAI assessments, reimbursement optimization, and Care Plan development, ensuring compliance with laws, regulations, and company standards. They provide education and training to MDS Coordinators to keep skills aligned with current reimbursement policies and federal quality reporting programs, audit for compliance and reimbursement optimization, and aim for optimal client outcomes. The role requires independent or team work, utilizing clinical, analytical, communication, and customer service skills, along with sound judgment and professionalism.What do we offer you?Creative, fun, and flexible working environmentBenefits including:Competitive salaries and bonusesPromotion, transfer, and advancement opportunitiesMeaningful work and job satisfactionReasonable working hoursCE opportunitiesPaid time offComprehensive health, dental, and life insurance401K with discretionary matchMileage and licensure reimbursementsFlexible Spending Account and HSAResponsibilitiesProvide supervision for MDS Solutions staff, including hiring, performance management, and terminations.Manage scheduling and billing hours for MDS Coordinators; provide ongoing feedback.Assist with orientation and onboarding of new MDS coordinators; track training and orientation timelines.Identify training and performance needs; create targeted improvement plans.Conduct regular audits of MDS coordinators to ensure coding and care planning meet standards.Maintain client relations through meetings and reports to review performance and satisfaction.Report client concerns to the VP of Consulting Operations and follow through with corrective plans.Stay current with standards, laws, regulations, and federal programs relevant to clinical care and reimbursement.Work with VP to establish billable hours expectations.Assist with other duties as directed by the VP of Consulting Operations.QualificationsBachelor’s degree in nursing or therapy disciplineMinimum of 5 years’ clinical experience, with 3+ years in RAI processCurrent and unrestricted RN or Therapist (OT, PT, SLP) licenseCurrent RAC-CT certificationStrong critical thinking and professional judgment skillsIntermediate proficiency in Microsoft Office; ability to learn billing softwareLeadership and interpersonal skillsKnowledge of PDPM and State Case Mix Reimbursement systemsUnderstanding of Medicare, Managed Care, and related regulationsEffective communication skills and ability to work with diverse disciplinesAbility to articulate RAI assessments and Care planning complexitiesStrong customer service skillsInitiative, creativity, and innovationEffective presentation and communication skillsReliable transportation, valid driver’s license, and ability to travel occasionallyKey Rehab is an equal opportunity employer/service provider. #J-18808-Ljbffr

Created: 2025-10-08