Regional Clinical Reimbursement Consultant - State Veterans Homes

Regional Clinical Reimbursement Consultant – State Veterans Homes

STGi is seeking qualified candidates for this position in connection with an active Request for Proposals (RFP). Hiring for this role is contingent upon STGi's selection as the successful awardee.

JOB SUMMARY:

The Regional Clinical Reimbursement Consultant (R CRC ) provides leadership and oversight of clinical reimbursement processes across multiple long-term care facilities within an assigned region. This role ensures accurate and compliant MDS completion, optimized reimbursement under PDPM, regulatory compliance, and consistent application of best practices while partnering with clinical, financial, and operational leaders to drive outcomes. Travel is required and is extensive throughout assigned region.

ESSENTIAL FUNCTIONS:

• Clinical Reimbursement & PDPM Oversight
• MDS & Documentation Support
• Compliance & Audit Management
• Education & Training
• Reporting & Analytics
• Collaboration & Leadership

REQUIRED EXPERIENCE AND SKILLS:

• Active Registered Nurse (RN) license in good standing
• Bachelor's degree in Nursing or related field (BSN required)
• Minimum 5–7 years of MDS and clinical reimbursement experience in long-term care
• Strong knowledge of PDPM, RAI Manual, ICD-10 coding, and CMS regulations
• Experience supporting audits and survey processes
• Ability to travel regularly within assigned region

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

The physical demands and work environment described herein is a representative of those that generally must be met by a team member to successfully perform the essential functions of this job:

• This position primarily involves sitting, standing, walking, twisting, reaching, bending/stooping, pushing and pulling (typical weight of 5 lbs. and maximum weight of 100 lbs., approximately), and lifting (minimum weight of 5 lbs. and maximum weight of 100 lbs., approximately)

• The position requires repetitive finger movements as well as hearing and talking on the phone and in person.

• Must be able to continuously deal effectively with stress created by residents, multiple tasks, noises, interruptions, and work cooperatively as part of the health care team while maintaining a pleasant attitude

DISCLAIMER

The preceding job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.