Regional Clinical Reimbursement Manager

Regional Clinical Reimbursement Manager

CareCore Health is seeking an experienced Regional Clinical Reimbursement Manager to support our skilled nursing facilities throughout the Northern/Central Ohio region. This is an excellent opportunity for an MDS professional who enjoys combining clinical expertise, regulatory knowledge, and hands-on facility support in a regional role.

This role will partner closely with facility MDS Coordinators, nursing leadership, and administrators to promote accurate assessments, timely completion of the MDS process, appropriate reimbursement, and continued regulatory compliance.

This is a Hybrid position that will require some travel throughout the Northern/Central Ohio areas.

Responsibilities

• Provide regional oversight and support for the MDS and RAI process across assigned facilities
• Support and mentor facility MDS Coordinators and interdisciplinary teams
• Review MDS assessments for accuracy, completeness, and timely submission
• Monitor Medicare, Medicaid, PDPM, and reimbursement-related processes
• Conduct audits and identify opportunities for improved documentation and coding accuracy
• Assist facilities with preparation for surveys and regulatory compliance
• Provide education and training related to MDS, RAI, PDPM, and documentation requirements
• Collaborate with clinical and operational leadership to improve processes and outcomes
• Assist with the interviewing, and selection of facility-level MDS Coordinators.
• Travel regularly throughout the Northern Ohio region to provide hands-on facility support

Qualifications

• Active Ohio RN license required
• Strong MDS experience in a skilled nursing/long-term care setting required
• Regional, multi-facility, or MDS leadership experience strongly preferred
• RAC-CT or RAC-CTA certification preferred
• Strong knowledge of RAI guidelines, PDPM, Medicare/Medicaid regulations, and reimbursement
• PointClickCare (PCC) experience required
• Strong auditing, organizational, communication, and training skills
• Ability and willingness to travel regularly throughout Northern Ohio

Benefits

• Medical, dental, and vision insurance
• 401(k) retirement plan
• Paid time off and paid holidays
• Mileage reimbursement for regional travel
• Continuing education and professional development opportunities
• Supportive regional and corporate leadership
• Opportunities for career growth within CareCore Health
• Employee discount and recognition programs

Why Join CareCore?

We are looking for a knowledgeable, collaborative MDS professional who can serve as a resource to our facility teams while helping ensure strong clinical documentation, compliance, and reimbursement practices. You'll have the opportunity to work directly with leadership and make an impact across multiple CareCore communities.