Regional Director of Clinical Reimbursement

Job Description

Job Description

Medical Facilities of America , a regional leader in post-acute rehabilitation and skilled nursing services, is seeking a qualified Registered Nurse (RN) to join our team as a Regional Director of Clinical Reimbursement (MDS) . This key position will oversee and support the MDS and clinical reimbursement processes across multiple skilled nursing and rehabilitation facilities within the Western Virginia region of the company.

In this role, you will ensure compliance, accuracy, and optimization of all Minimum Data Set (MDS) processes, driving both quality outcomes and financial integrity. You’ll serve as a resource and mentor to facility MDS Coordinators and interdisciplinary teams, while leading initiatives that strengthen care delivery and reimbursement performance across the region.

What We Offer

• Competitive salary commensurate with experience.

• Comprehensive health benefits (Medical, Dental, Vision)

• 401(k), Flexible Spending Account, and additional elective benefits

• Generous Paid Time Off (PTO)

• Ongoing leadership development and career advancement opportunities

What You'll Do

• Provide regional oversight and leadership to facility MDS and clinical reimbursement teams.

• Ensure accurate and timely completion of MDS assessments in accordance with federal and state regulations.

• Monitor and analyze case mix, PDPM categories, and reimbursement trends to optimize performance.

• Conduct regular audits and provide feedback to maintain compliance and documentation integrity.

• Develop and deliver training programs for facility MDS staff to strengthen clinical documentation and RAI process understanding.

• Collaborate with Regional and Company Leadership to identify opportunities for improvement and implement strategic initiatives.

• Partner with clinical and financial teams to ensure alignment between care delivery, documentation, and reimbursement outcomes.

• Participate in Quality Assurance and Performance Improvement (QAPI) initiatives to promote excellence in resident care.

What You Need

• Active, unencumbered licensure as a Registered Nurse (RN) in Virginia.

• Proven experience in MDS coordination and clinical reimbursement.

• Expert-level knowledge of MDS 3.0, PDPM, RAI process, and Medicare/Medicaid regulations.

• Strong analytical, leadership, and communication skills.

• Proven ability to train, mentor, and support interdisciplinary teams.

• Proficiency with MDS software systems and Microsoft Office Suite (Word, Excel, etc.).

• Willingness and ability to travel regionally to assigned facilities.