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Regional Director of Clinical Reimbursement

Clayton Clinical

Job Description

Job Description

Regional Director of Clinical Reimbursement (RN)

Location: Louisville, Kentucky / Kentucky Region
Regional Travel Required

Are you a results-driven Registered Nurse with extensive MDS, PDPM, and clinical reimbursement expertise ? Do you thrive in a regional leadership role where your knowledge directly impacts reimbursement accuracy, regulatory compliance, clinical outcomes, and financial performance across multiple skilled nursing facilities?

We are seeking an experienced Regional Director of Clinical Reimbursement (RN) to support our skilled nursing facilities throughout the Kentucky/Louisville region .

This is a high-impact regional leadership opportunity for an RN who understands the complexities of clinical reimbursement and knows how to develop strong MDS teams, identify opportunities, and drive results.

The Impact You’ll Make

As the Regional Director of Clinical Reimbursement, you will serve as a strategic resource and subject matter expert for facility and regional leadership. You will provide oversight, education, and support to ensure accurate reimbursement, strong documentation practices, regulatory compliance, and successful MDS processes throughout the region.

You will partner closely with MDS Coordinators, Directors of Nursing, Administrators, interdisciplinary teams, and regional leadership to identify opportunities and implement strategies that strengthen both clinical and financial outcomes.

Key Responsibilities
  • Lead clinical reimbursement and MDS strategy across multiple skilled nursing facilities throughout the Kentucky region

  • Monitor reimbursement performance and identify opportunities to improve accuracy and capture appropriate reimbursement

  • Ensure compliance with federal and state regulations related to MDS, Medicare, Medicaid, PDPM, and clinical reimbursement

  • Provide oversight and guidance regarding ARD scheduling, MDS completion timelines, supporting documentation, and coding accuracy

  • Review facility processes to ensure documentation supports the resident's clinical condition and services provided

  • Lead regional reimbursement, MDS, and revenue-focused meetings

  • Educate, mentor, and support MDS Coordinators and interdisciplinary team members

  • Assist with interviewing, onboarding, training, and development of MDS leadership

  • Conduct facility visits, audits, and reviews to identify opportunities and implement corrective action when necessary

  • Serve as a clinical reimbursement subject matter expert during audits, denials, surveys, acquisitions, and operational transitions

  • Partner with facility and regional leadership to monitor trends, resolve reimbursement concerns, and drive measurable results

  • Promote consistency and best practices across facilities throughout the region

Required Qualifications
  • Active Registered Nurse (RN) license in Kentucky or ability to obtain appropriate Kentucky licensure

  • Minimum of 3 years of MDS and/or clinical reimbursement experience within a Skilled Nursing Facility or Long-Term Care environment

  • Strong working knowledge of MDS, PDPM, Medicare, Medicaid, reimbursement regulations, and documentation requirements

  • Multi-facility or regional clinical reimbursement experience strongly preferred

  • Must reside in or be willing to relocate to the Kentucky/Louisville area

  • Ability and willingness to travel throughout the assigned region

  • Strong analytical skills with the ability to identify trends and reimbursement opportunities

  • Excellent leadership, organizational, education, and communication skills

  • Ability to effectively collaborate with facility, regional, and corporate leadership

  • Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook

What We Offer
  • Competitive compensation based on experience and expertise

  • Generous paid time off

  • 401(k) retirement plan

  • Daily Pay options

  • Comprehensive medical, dental, vision, and disability benefits

  • Wellness and employee support programs

  • Collaborative and supportive leadership environment

  • Professional development and leadership training

  • Opportunity to make a measurable impact across multiple skilled nursing facilities

Apply Today

If you are an experienced RN clinical reimbursement leader who understands MDS, PDPM, and the operational side of skilled nursing reimbursement, we want to hear from you.

Join our team and use your expertise to develop strong MDS teams, improve reimbursement accuracy, strengthen compliance, and drive results across our Kentucky facilities.

Vacancy posted 2 days ago
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