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Director of Clinical Documentation and Reimbursement (Registered Nurse)

RCM Healthcare Services

Bronx, NY

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JOB DETAILS
SALARY
$150,000–$150,000
SKILLS
Analysis Skills, Case Management, Clinical Information, Clinical Study Publications, Communication Skills, Compensation and Benefits, Data Analysis, Documentation Plan, Facilities Planning, Federal Laws and Regulations, Follow Through, Health Information Management, Healthcare, Healthcare Reimbursement, Interpersonal Skills, Managed Care, Medicaid, Medicare, Medicare Reimbursement, Nursing, Operational Strategy, Organizational Skills, Performance Management, Presentation/Verbal Skills, Project/Program Management, Quality Assurance, Quality Metrics, Quality of Care, Registered Nurse (RN), Regulations, Regulatory Requirements, Reimbursement, State Laws and Regulations, Strategic Planning, The Joint Commission (TJC), Time Management, Writing Skills
LOCATION
Bronx, NY
POSTED
Today
Director of Clinical Documentation and Reimbursement
Compensation and Benefits
Salary: $150,000
  • Benefits include health insurance, retirement plans, paid time off, and professional development opportunities.
Location: Bronx, New York
Organization: Gorgeous skilled nursing facility
Position Summary
The Director of Clinical Documentation and Reimbursement is responsible for the overall operational and strategic planning of the Clinical Documentation and Reimbursement (MDS) Department and Health Information Management (HIM) Department. This position will ensure that all operational and regulatory requirements are maintained related to the MDS and Resident Assessment Instrument (RAI) process.
Responsibilities
Key Duties:
  • Collaborates with other department heads to utilize objective information from the clinical documentation to drive the highest quality of care. 
  • Leads the strategic planning development related to Medicare/ Medicaid reimbursement and Managed Care Case Management.
  • Monitors and incorporates facility wide education plans related to MDS updates, payment reforms and changes to quality measures. 
  • Analyzes and tracks data related to MDS item sets to support organizational quality assurance/ performance improvement plan. 
  • Audits and tracks all aspects of the RAI process to ensure performance is reflective of NYS DOH regulatory statues and standards.
Qualifications
Education:
  • Bachelor’s degree in nursing required, Master’s Degree preferred.
Licenses and Certifications:
  • NYS RN license required with required following experience a plus: Minimum 3 years of RAI process and SNF reimbursement experience.
  • Completion of New York State approved PRI assessor program preferred, RAC-CT preferred. 
Skills:
  • Knowledge of Federal and State regulations and NYS nursing standards required.  Familiarity with Medicaid and Medicare regulations required.
  • Required Experience with data extraction and manipulation required.
  • SNF Based Quality Metrics (ie QM, QRP, VBP models)
  • Demonstrated strong analytical, project management Skills
  • Effective oral and written communication and interpersonal skills required. Must be able to communicate with clients and employees of all backgrounds and educational levels.

About Us
RCM Healthcare Services’ mission is to provide opportunities for qualified candidates across medical professions. We deliver timely results and have built a reputation of trust with our clients and candidates. Since 1975, we have been providing staffing solutions to many of the finest healthcare institutions across the nation and careers for thousands of candidates. As professional career opportunity matchmakers, we follow up and follow through to help our clients and candidates reach their career and life goals. We proudly hold the Joint Commission Gold Seal of Approval as well.
 
Equal Employment Opportunity & Reasonable Accommodation RCM Technologies is an equal opportunity employer and values diversity. We are committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state laws. If you require a reasonable accommodation to apply for or perform this role, please contact us and we will engage in an interactive process to support your needs.

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About the Company

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RCM Healthcare Services