Director of Clinical Reimbursement & Quality (RN preferred)

Job Description

Job Description

About the role

We are seeking an experienced, results‑driven Director of Quality to lead our quality, safety, infection prevention, and regulatory readiness programs across a 400+ bed skilled nursing facility. This is a senior clinical/quality leadership role reporting to the Chief Operating Officer and working closely with Nursing, MDS, Medical Director, and Operations.

Key responsibilities

- Lead QAPI and quality improvement strategy; set and track KPIs (CMS star measures, readmissions, HAIs, falls, pressure injuries).

- Oversee infection prevention program and surveillance; lead survey readiness and plan‑of‑correction efforts.

- Direct data collection/analysis and reporting (internal dashboards, electronic health record/PointClickCare or equivalent, external quality reporting).

- Collaborate with clinical leaders on clinical pathways, staff education, and process redesign to improve outcomes.

- Manage the QA/PI team, clinical auditors, education team, and contractors as needed; develop policies and staff training.

- Prepare and present quality reports to executive leadership and the Quality Committee

Required qualifications

- Active, unencumbered NYS RN license (if non‑RN candidate, please note — but RN strongly preferred).

- Bachelor of Science in Nursing (BSN) required; Master’s or additional quality/healthcare degree preferred.

- Minimum 5 years of long‑term care / skilled nursing experience, with at least 2 years in quality, infection prevention, or clinical leadership.

- Demonstrated success improving CMS quality measures, reducing readmissions/infections, and survey readiness.

- Strong data/analytics skills (experience with PointClickCare, Excel) and quality certification (CPHQ, Lean Six Sigma preferred)

- Excellent communication skills and ability to lead interdisciplinary teams.

Core Organizational Competencies :

• St. John’s Brand Characteristics – Embrace living by being Friendly, Respectful, Responsive, Compassionate, Innovative and Fun towards elders, families and colleagues.
• Teamwork – Actively participates. Assists team members; offers encouragement. Acknowledges/welcomes elders. Keeps team members informed. Recognize achievements and efforts of others.
• Job Knowledge - Consistently demonstrates working knowledge of all aspects of job. Remains current on job related changes and trends.
• Planning/Organization – Demonstrates initiative; plans appropriately. Uses time, materials, resources effectively. Organizes work to ensure commitment and priorities.
• Productivity – Consistently maintains high activity levels and efficiently produces acceptable volume of work. Consistently meets deadlines and commitments.
• Quality – Consistently produces accurate, timely work which meets required quality standards. Pays attention to detail. Sets high standards of performance for self and others; actively seeks continuous improvement. Ensures highest quality elder-driven care is provided.
• Reliability – Consistently delivers on commitments. Can be counted on to accomplish tasks without follow-up. Available when required by elder or team, and can be counted on to help or assist when needed. Responds in a timely manner.
• Demeanor (attitude) – Embraces change with optimism. Addresses concerns appropriately. Positively communicates. Good listener. Consistently maintains a positive demeanor.

Preferred

- Prior experience in a 200+ bed facility (experience with a 400‑bed facility or multi‑site oversight a plus).

- Proven leadership in QAPI, MDS collaboration, and regulatory interactions with NYS DOH/CMS.

What we offer

- Competitive base salary range $110,000–$145,000 + performance bonus.

- Comprehensive benefits: medical/dental/vision, 401(k) with employer match, paid time off, CME/education support.