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Clinical Reimbursement Program Manager

Ciena Healthcare Management

Southfield, MI
1 month ago

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This job listing is no longer available for applications. The position may have been filled or the posting period has ended.

Job Description

As a Clinical Reimbursement Program Manager, you will lead the development and implementation of clinical reimbursement programs while ensuring compliance and best practices in MDS processes. This strategic role oversees skilled nursing facilities in Michigan and Ohio, empowering teams with education and tools to optimize reimbursement processes.

Key Responsibilities

  • Design and implement clinical reimbursement programs
  • Develop compliance tools and documentation standards
  • Conduct root cause analyses of reimbursement trends
  • Provide education and training on reimbursement best practices
  • Monitor regulatory changes affecting reimbursement
  • Collaborate with leadership on reimbursement strategies
  • Support reimbursement audits and response plans
  • Participate in QAPI initiatives
  • Assist in onboarding new staff

Required Qualifications

  • Licensed Registered Nurse (RN) with active license
  • Minimum of 3 years of experience in clinical reimbursement, MDS, or case mix management
  • In-depth knowledge of PDPM, MDS 3.0, Medicare/Medicaid regulations

Preferred Qualifications

  • RAC-CT certification
  • Experience developing educational content for clinical staff

Benefits & Perks

Competitive payMedical, dental, and vision insurance401K with matching fundsLife insuranceEmployee discountsTuition reimbursementStudent loan reimbursement