Regional Reimbursement Nurse Consultant

Regional MDS / PDPM / CMI / RAI ConsultantAre you ready to make a change? We are seeking an experienced Regional MDS / PDPM / CMI / RAI Consultant to provide remote reimbursement, MDS, PDPM, Case Mix Index, and RAI support to our long-term care and skilled nursing facilities.This position will provide regional oversight to ensure accurate MDS completion, proper PDPM classification, optimized reimbursement, accurate case mix, regulatory compliance, and strong interdisciplinary team processes. Quarterly travel to assigned facilities will be required for on-site audits, training, clinical reimbursement review, and team support.This role is ideal for a highly organized MDS professional with strong knowledge of PDPM, RAI guidelines, CMI, care planning, Medicare documentation, and long-term care reimbursement systems. This is a travel position. Looking for local to Iowa or Nebraska.Key ResponsibilitiesProvide regional oversight for MDS, PDPM, CMI, and RAI processesMonitor timely and accurate MDS completion across assigned facilitiesReview PDPM classifications, clinical documentation, diagnosis coding, and reimbursement accuracySupport Case Mix Index improvement through accurate assessment and documentationAudit MDS assessments for accuracy, compliance, and missed reimbursement opportunitiesReview Medicare Part A documentation and skilled coverage supportAssist with Triple Check and Medicare meetingsSupport facility MDS Coordinators, DONs, Administrators, and interdisciplinary teamsReview care plans for accuracy and alignment with MDS assessmentsMonitor ARD schedules, assessment calendars, significant change assessments, and discharge assessmentsProvide education and coaching to facility MDS and clinical teamsAssist with RAI Manual interpretation and regulatory complianceIdentify trends, risks, late assessments, coding errors, and reimbursement concernsParticipate in monthly or quarterly reimbursement reviews with regional leadershipTravel quarterly to assigned facilities for audits, training, and operational supportQualificationsActive RN license requiredLong-term care/skilled nursing experience requiredMDS experience requiredStrong knowledge of PDPM, RAI, CMI, Medicare, and Medicaid case mix processesExperience with multi-facility MDS oversight preferredRAC-CT certification preferredExperience with Triple Check, Medicare meetings, care planning, and reimbursement audits preferredStrong understanding of RAI Manual requirementsAbility to work independently from homeStrong communication, organization, auditing, and follow-through skillsAbility to travel quarterly to assigned facilitiesExperience with PCC or similar electronic health record system preferredCompensation & BenefitsCompetitive salary or hourly ratePrimarily remote/work-from-home positionQuarterly travel reimbursementMileage reimbursementLodging and meal reimbursement when overnight travel is requiredLicensure or certification reimbursement as approvedOpportunity to support multiple facilities and directly impact reimbursement accuracy, compliance, and clinical outcomes