VP-Clinical Assessment
Woodmont Health Campus
Position Overview Provides executive leadership and strategic oversight of the organization’s resident assessment and clinical reimbursement functions (MDS/RAI/CAAs/Care Planning) across assigned regions. Ensures enterprise-wide compliance, accuracy, and optimization of assessment processes to support quality outcomes, regulatory adherence, and financial performance. Serves as a key advisor to executive leadership, driving standardization, innovation, and continuous improvement in assessment practices aligned with federal and state regulations. Roles and Responsibilities Leads the strategic direction, standardization, and performance optimization of the MDS/RAI process across multiple campuses or regions. Develops and executes initiatives that improve clinical quality indicators, reimbursement accuracy, and regulatory compliance. Partners with the Chief Nursing Officer, Chief Operating Officer, Division Vice Presidents, and other senior leaders to align assessment strategy with organizational goals. Influences decision‑making through data‑driven insights and expert consultation. Maintains accountability for system‑wide compliance with all federal and state regulations governing the Resident Assessment Instrument (RAI). Proactively identifies risk areas, leads mitigation strategies, and ensures audit readiness across the portfolio. Oversees performance metrics related to MDS accuracy, timeliness, case mix index (CMI), and reimbursement outcomes. Leverages data analytics to identify trends, drive accountability, and implement targeted improvements. Provides high‑level consultation to Executive Directors, Directors of Health Services, and MDS leaders to address complex clinical, operational, and reimbursement challenges. Guides development and execution of corrective action plans. Leads, mentors, and develops a team of regional consultants and MDS specialists, including MDS float and audit team resources. Establishes performance expectations, ensures accountability, and builds organizational bench strength with the Director of Assessment Support. Designs and implements enterprise‑wide education, training, and quality improvement initiatives related to MDS processes, value‑based care programs, quality, and interdisciplinary care planning. Partners with clinical, finance, compliance, and operations teams to ensure alignment between assessment practices and organizational performance objectives. Represents the organization with regulatory agencies, professional associations, and industry groups. Maintains strong external relationships to stay ahead of regulatory and industry changes. Provides regular executive‑level reporting on assessment performance, compliance risks, and improvement initiatives. Communicates insights, recommendations, and outcomes to senior leadership and board‑level stakeholders as appropriate. Other duties as assigned. Qualifications Associate Degree. 12–15 years of relevant experience. Licenses and Certifications Current unencumbered registered nursing license in the state of practice. Certification as a Nurse Assessment Coordinator preferred. Bachelor’s degree preferred. Physical Requirements Sitting, standing, bending, reaching, stretching, stooping, walking, and moving intermittently during working hours. Must be able to lift at least 20 lbs. Must be able to maintain verbal and written communication with co‑workers, supervisors, residents, family members, visitors, vendors, and all business associates outside of the health campus. Location US-KY-Louisville Benefits Competitive salaries and weekly pay 401(k) Company Match Mental Health Support Program Student Loan Repayment and Tuition Reimbursement Health, vision, dental & life insurance kick in on the first of the month after your start date First‑time homebuyers’ program
HSA/FSA
And so much more! Equal Opportunity Employer As one of Fortune’s Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor’s Top 100 Best Companies to Work, Trilogy is proud to be an equal opportunity employer committed to helping you reach your full potential and to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. #J-18808-Ljbffr Woodmont Health Campus- Become a part of our caring community Humana maintains a robust clinical risk management function to ensure effective risk mitigation,... ...President - Clinical Operations. Responsibilities Identify, assess, and report operational and clinical risks within CM/UM processes...SuggestedApprenticeship
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