Director of Facility Based Clinical Reimbursement

Director of Facility-Based Clinical Reimbursement

Hillcrest Health & Living is seeking an experienced and strategic Director of Facility-Based Clinical Reimbursement (RN) to lead and oversee all reimbursement-related functions across our post-acute and long-term care communities. This individual will serve as a key resource for ensuring compliance, accuracy, and optimization of the MDS and PDPM processes, while supporting our mission of Inspiring people to live their best lives.

Key Responsibilities

• Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.

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

• Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.

• Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer-specific reimbursement systems.

• Develop and implement policies and procedures to ensure consistent documentation and coding practices.

• Partner with clinical and financial leaders to align care documentation with reimbursement compliance.

• Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.

• Support education, training, and competency development for facility reimbursement teams.

• Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.

• Represent the reimbursement department in interdisciplinary and corporate-level meetings.

Qualifications

• Current Registered Nurse (RN) license in the state of Nebraska (or compact state).

• Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.

• Prior experience in post-acute care, long-term care, or skilled nursing facility management required.

• Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and clinical documentation requirements.

• Proven ability to lead, educate, and mentor multi-site clinical reimbursement teams.

• Excellent analytical, organizational, and communication skills.

• Ability to travel periodically between facilities.

Why Hillcrest

At Hillcrest, we believe in providing a career that helps you thrive—both professionally and personally. We offer:

• Comprehensive health, dental, and vision insurance options

• Paid time off 

• Tuition reimbursement and student loan repayment for nurses

• Career growth and development opportunities

• A mission-driven culture centered on Integrity, Compassion, Respect, Teamwork, and Service