Director of Clinical Reimbursement

Job overview

The Director of Clinical Reimbursement role is based onsite in Daytona Beach, FL, with travel to facilities in Wisconsin, Tennessee, Kentucky, and Florida. Compensation is not specified. The role provides training, analysis, advice, and consultation to facilities and teams in its assigned area. The director helps facilities maintain compliant and effective Medicare, Medicaid, managed-care, and state case-mix payment processes. Through audits, trend analysis, recommendations, and follow-up, the role supports accurate reimbursement performance and regulatory compliance.

What you'll do

• Provide consultation, training, and support on Medicare, managed-care, and state case-mix payment systems
• analyze processes for regulatory and company-policy compliance
• audit MDS assessments and supporting documentation
• identify trends and deviations in payment results
• recommend and follow up on process changes
• communicate recommendations to management
• liaise with the state on case-mix processes and MDS submissions
• assist with recruitment and interviews for MDS vacancies.

What we're looking for

Skills & competencies

clinical reimbursement

medicare

medicaid

managed care

state case mix

mds audits

regulatory compliance

daytona beach fl

travel to facilities in four states

Work arrangement

• Weekend coverage required

About the employer

Bedrock Healthcare is hiring for this role. Industry: Nursing Care Facilities (Skilled Nursing Facilities). Sector: 62.