Regional MDS Coordinator
Cascades Healthcare
Job Description
Job Description
Take Your MDS Career to the Regional Level!
Are you a meticulous and highly skilled MDS registered nurse looking to make a broader impact? We are seeking a dynamic Regional MDS Coordinator to join our team. If you are passionate about ensuring high-quality care, optimizing clinical reimbursement, and supporting multiple skilled nursing facilities, this is the role for you!
This is a strong opportunity for an experienced MDS professional who is ready to expand their leadership impact across multiple communities while helping drive clinical excellence, compliance, and reimbursement success.
We pride ourselves on our inclusive company culture, commitment to our core values, and investment in our team's professional development. In this multi-facility role, you will travel frequently to provide hands-on, in-facility support, education, and technical advancement advice for center-based MDS Coordinators.
Why Join Us?
- Make an Impact: Step into a leadership role with a supportive and collaborative leadership team where you will drive interdisciplinary team collaboration and clinical excellence across the region.
- Exceptional Benefits: Enjoy a competitive salary, based on experience, and a comprehensive benefits package including health, dental, and vision insurance, generous paid time off, retirement planning with 401(k) matching, mileage reimbursement, and travel support.
- Professional Growth: We encourage continuing education and offer opportunities to upskill, cross-train, and earn additional certifications as appropriate. Opportunities for advancement and professional development.
Job Description
Position Title: Regional Director of Clinical Reimbursement
Employment Type: Full-Time with required travel
Role Overview: The Regional Director of Clinical Reimbursement is responsible for the oversight, assessment, education, and implementation of programs relating to the Medicare Prospective Payment System (PPS), Medicaid Case Mix Index (CMI), and MDS processes across multiple regional facilities.
This position requires frequent travel to provide facility MDS coordinators with on-site ongoing support and training. You will ensure compliance with evolving CMS regulations and optimize clinical reimbursement under the Patient-Driven Payment Model (PDPM).
Key Duties and Responsibilities:
- Multi-Facility Support & Oversight: Provide direct oversight, educational, and technical support for center-based MDS, OBRA, and PPS coordinators. Monitor caseloads to prevent reimbursement denials and ensure financial optimization.
- Training & Education: Create custom training programs to promote team efforts and educate staff on common coding errors, supportive documentation, and the most prevalent PDPM and Case Mix Index (CMI) missed opportunities.
- Compliance & Quality Assurance: Prevent MDS-related survey deficiencies and manage medical review risks. Maintain up-to-date knowledge of the MDS RAI manual, Quality Measures (QM), and SNF QRP/VBP guidelines.
- Clinical Accuracy under PDPM: Proactively assess and verify that clinical conditions, such as behavioral symptoms, depression (PHQ 2-9), isolation, and Section GG self-care/mobility scores, are captured accurately to elevate Nursing and NTA case-mix reimbursement.
- Interdisciplinary Collaboration: Work closely with facility leadership, therapy, dietary, social work, and providers to ensure accurate documentation, ICD-10 coding specificity, and effective person-centered care planning.
Required Qualifications & Skills:
- Certifications: Active Utah RN license required with compact license preferred. RAC-CT credential strongly preferred.
- Experience: Minimum of three years experience in a long-term care setting managing Medicare and Medicaid MDS, CMI, care planning, Quality Measures, QRP/VBP outcomes, and state performance programs (i.e., UPL). Previous training or leadership experience at a regional or corporate level is highly desired.
- Expertise: Strong knowledge of MDS 3.0, PDPM and state specific CMI structures, accurate ICD-10 coding, and skilled nursing documentation requirements.
- Additional Skills:
- Must possess an a naturally friendly, pleasant, and good-natured personality, critical thinking skills, the ability to perform under pressure, and meticulous professional work ethics.
- Experience training, mentoring, and supporting interdisciplinary teams.
- Strong audit, compliance review, and reimbursement analysis skills.
- Ability to manage multiple priorities across multiple facilities.
- Experience with EMR, preferably PointClickCare, clinical assessments, and care planning
- Solid communication, teamwork, adaptability, problem solving, and time management skills
About Cascades Healthcare
Cascades Healthcare provides skilled nursing and rehabilitation services with a focus on quality care, strong clinical outcomes, and support for the teams who serve our residents every day.
Our residents depend on consistent, knowledgeable, and compassionate care. We value teamwork, integrity, accountability, and professional development, and we are committed to building a supportive environment across our facilities.
Cascades Healthcare is actively interviewing for this position.
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