Director of Clinical Reimbursement (MDS)

Illuminus•Fitchburg, WI

5h•Onsite

About The Position

At Illuminus, our work is grounded in faith and guided by a deep commitment to dignity, vibrance, and love for older adults and the families who place their trust in us. As a not-for-profit senior living management company, we exist to strengthen communities by providing operational expertise, financial stewardship, and—above all—exceptional, compassionate care. We are seeking a Director of Clinical Reimbursement (MDS) who shares this mission and is ready to lead with both expertise and empathy. This is an onsite, Director-level leadership role supporting our skilled nursing communities within WI and MN. The Director will oversee and develop a team of Clinical Reimbursement Specialists while ensuring integrity, accuracy, and excellence in MDS and reimbursement practices—so our caregivers can focus on what matters most, helping our residents live their light. Why Join Illuminus Mission-Driven Leadership: Your work directly supports quality care, resident dignity, and sustainable operations Opportunity to Lead and Grow: Build, mentor, and inspire a team of Clinical Reimbursement Specialists Meaningful Collaboration: Partner closely with campus leaders, nursing teams, and Clinical Nurse Consultants Faith-Based, Values-Centered Culture: Serve within an organization that prioritizes compassion, integrity, and stewardship Visible Impact: Influence outcomes across multiple communities and support long-term organizational strength If you are an experienced reimbursement leader who believes that operations, quality care, and mission are inseparable, this role offers the opportunity to lead with intention and make a lasting difference. Join Illuminus and help ensure that dignity, vibrancy, and love remain at the heart of every community we serve.

Requirements

Onsite work daily, some travel to skilled nursing communities within WI and MN
Licensed Registered Nurse (RN) in the state of Wisconsin.
Proven experience in Skilled Nursing Facility reimbursement.
Demonstrated leadership skills with the ability to mentor and motivate teams.
AANAC Resident Assessment Coordinator Certification (RAC-CT) required.
Commitment to quality outcomes and services for all individuals.
Ability to relate well to all individuals.
Ability to maintain and protect the confidentiality of information.
Ability to exercise independent judgment and make sound decisions.
Ability to adapt to change.

Responsibilities

Lead and support the accurate and timely completion of the Minimum Data Set (MDS) across multiple skilled nursing facilities
Provide coaching, mentorship, and professional development for multiple Clinical Reimbursement Specialists
Benchmark, monitor, and analyze reimbursement KPIs, identifying trends and opportunities
Audit reimbursement practices and share insights with campus and enterprise leaders
Drive process improvement initiatives that support compliance, quality care, and responsible financial stewardship
Partner with Clinical Nurse Consultants to promote strong clinical outcomes and margin management
Ensure alignment with current and evolving Medicare and Medicaid regulations
Serve as a subject matter expert in AANAC standards, Case Mix Index (CMI), ICD coding, and MDS best practices
Lead education and in-services for health center staff on regulatory changes and reimbursement strategies
Manage denials and appeals at both the campus and enterprise level
Monitor Quality Measures (QMs) and assess their impact on CMS publicly reported data
Participate in on-call responsibilities, as assigned

Benefits

Employee Referral Bonus Program.
Educational Advancement/Training Opportunities (Wound care, IV administration etc., provided by our Illuminus Institute or Other External Qualifying Educational institution)
Paid Time Off and Holidays acquired from day one of hire.
Health (low to no cost), Dental, & Vision Insurance
Flexible Spending Account (Medical and Dependent Care)
401(k) with Company Match
Financial and Retirement Planning at No Charge
Basic Life Insurance & AD&D - Company Paid
Short and Long Term Disability - Company Paid
Voluntary Ancillary Coverage
Employee Assistance Program
Benefits vary by full-time, part-time, and PRN status.