Director of Reimbursement and Quality
About The Position
The Director of Reimbursement and Quality is responsible for supervising Regional MDS Nurses and implementing measures to improve quality measures and maximize compensation. This role involves monitoring and auditing MDS and Quality Measures, ensuring familiarity with current payment structures (PDPM, CMI, etc.) and the RAI manual, and guaranteeing timely submission of assessments. The Director will collaborate with Regional MDS Nurses to establish schedules and best practices for accurate and timely MDS assessments, and may be involved in disciplinary actions for MDS staff. Additionally, the Director must be knowledgeable of federal and state agency regulations, implement measures to meet regulatory and legal requirements, and participate in community events and marketing plans. Professional representation of the facility, effective communication, and maintaining confidentiality (including HIPAA compliance) are essential. Accurate record-keeping and adherence to Legacy's Compliance program, Code of Conduct, and Dress Code are also required.
Requirements
- Freedom from illegal use of drugs.
- Freedom from use and effects of drugs and alcohol in the workplace.
- Not found guilty by a court of law of abusing, neglecting, or mistreating individuals in a health care related setting.
- Completion of an accredited nursing program.
- 5+ Years MDS experience.
- Current valid LPN/LVN or RN license.
Nice To Haves
- Leadership experience preferred.
Responsibilities
- Supervision of Regional MDS Nurses.
- Implementing measures to improve quality measures.
- Maximizing compensation.
- Monitoring and auditing MDS and Quality Measures.
- Ensuring timely submission of assessments.
- Working with Regional MDS Nurses to develop schedules and best practices for completing MDS assessments timely and accurately.
- Participating in disciplinary action of MDS staff.
- Ensuring familiarity with federal and state agency regulations and requirements.
- Putting measures in place to meet regulatory and legal requirements.
- Participating in community events and marketing plans and programs as needed.
- Acting in ways that promote professional and positive representation of the facility to the community.
- Communicating in a professional and courteous manner using effective verbal and non-verbal communication skills with residents, their families, co-workers, and vendors.
- Maintaining confidentiality of department, resident, employee information, communication, and documentation as well as compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulations.
- Maintaining accurate records of work activities, training, and attendance as required by Legacy policy.
- Maintaining compliance with Legacy's Compliance program and plan.
- Adhering to Legacy's Code of Conduct and Dress Code.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
