Regional Director of Clinical Operations and Reimbursement

Volare Health, LLC•Eugene, OR

1d•Hybrid

About The Position

Volare Health is seeking an experienced and results-driven Regional Director of Clinical Operations & Reimbursement to provide strategic clinical leadership and reimbursement oversight across our Oregon skilled nursing facilities. This critical leadership position combines the responsibilities of Regional Clinical Operations and Clinical Reimbursement Support, ensuring excellence in resident care, regulatory compliance, quality outcomes, and reimbursement performance. The ideal candidate will possess a strong background in skilled nursing operations, regional clinical leadership, MDS management, PDPM optimization, and survey preparedness. This role serves as a trusted partner to facility leadership teams, providing mentorship, guidance, and operational support to drive exceptional clinical and financial outcomes.

Requirements

Current Registered Nurse (RN) license in Oregon or ability to obtain Oregon licensure promptly.
Minimum of 5 years of skilled nursing facility (SNF) leadership experience.
Experience as a Director of Nursing, Regional Clinical Consultant, Regional Director of Clinical Operations, Clinical Reimbursement Specialist, or similar role.
Extensive knowledge of MDS, PDPM, Medicare, Medicaid, and reimbursement processes.
Strong understanding of long-term care regulations and survey processes.
Multi-facility clinical leadership experience.
Demonstrated success improving clinical outcomes and reimbursement performance.
Strong leadership, communication, coaching, and problem-solving skills.
Ability to travel regularly throughout Oregon.

Nice To Haves

Experience supporting facilities throughout Oregon.
RAC-CT certification or similar reimbursement credentials.
Proven success mentoring Directors of Nursing, MDS Coordinators, and clinical leadership teams.
Experience leading facilities through successful surveys and regulatory reviews.

Responsibilities

Provide leadership, support, and oversight to facility clinical teams across multiple locations.
Monitor clinical performance metrics and develop action plans to improve outcomes.
Mentor and develop Directors of Nursing, Assistant Directors of Nursing, MDS Coordinators, and other clinical leaders.
Support facilities in maintaining high standards of resident-centered care.
Assist with recruitment, onboarding, and retention of clinical leadership staff.
Promote best practices and standardization across all assigned facilities.
Ensure ongoing compliance with federal, state, and local regulations.
Conduct clinical audits and mock surveys to maintain survey readiness.
Provide guidance during state surveys and assist with plans of correction.
Monitor compliance initiatives and implement corrective actions when necessary.
Support facilities in achieving and maintaining strong survey outcomes.
Oversee MDS processes and reimbursement systems across assigned facilities.
Ensure accuracy and timeliness of MDS assessments and documentation.
Monitor PDPM performance and identify opportunities for reimbursement optimization.
Conduct reimbursement reviews and audits to maximize revenue integrity.
Partner with facility teams to improve case mix management and reimbursement outcomes.
Provide education and support related to Medicare, Medicaid, and payer requirements.
Analyze quality measures, clinical indicators, and operational data.
Develop and implement strategies to improve clinical outcomes and resident satisfaction.
Support quality assurance and performance improvement (QAPI) initiatives.
Collaborate with facility leadership to achieve organizational goals and performance targets.