SVP of Clinical Reimbursement

Volare Health, LLC • Louisville, KY

5d

About The Position

We are seeking a strategic, results-driven Senior Vice President of Clinical
Reimbursement (RN) to lead and optimize reimbursement operations across our
organization. This executive role partners closely with clinical and operational
leaders to ensure accurate reimbursement, regulatory compliance, and top-tier
quality outcomes.

You’ll serve as the go-to expert in RAI, PDPM, and Case Mix, driving education,
performance improvement, and financial integrity across multiple skilled nursing
facilities.

Requirements

• Active Registered Nurse (RN) license
• Associate or bachelor’s degree in nursing
• 3+ years of hands-on experience with the RAI process
• Strong expertise in:
• PDPM reimbursement model
• State Case Mix systems
• Deep understanding of long-term care regulations and compliance

Nice To Haves

• Multi-facility or regional experience
• Experience improving CMS Five-Star ratings

Responsibilities

• Lead & Influence
• Serve as the clinical reimbursement authority across all facilities
• Guide MDS Coordinators and regional teams on RAI, PDPM, and Case Mix
• Drive Performance
• Monitor Medicare and Case Mix performance metrics
• Identify trends and implement strategies to maximize reimbursement
• Elevate Quality
• Partner with Regional Nurse Consultants to improve:
• Quality Measures (QM)
• CMS Five-Star Ratings
• Support interdisciplinary teams (IDT) with education and systems development
• Ensure Compliance & Accuracy
• Oversee RAI process compliance with federal and state regulations
• Support accurate coding, billing, and claims submission
• Lead Improvement Initiatives
• Drive QAPI efforts including:
• Trend analysis
• Root Cause Analysis
• Solution implementation and tracking
• Support Survey Readiness
• Participating in mock surveys and regulatory preparation
• Ensure facilities are always audit-ready

Benefits

• Comprehensive benefits package (Medical, Dental, Vision, 401(k), PTO, etc.)
• Career growth & executive visibility within a growing organization
• Supportive leadership culture focused on quality care and innovation

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Education Level: Associate degree
• Number of Employees: 1-10 employees