Director of Clinical Reimbursement & Quality Improvement

Are you a detail-driven clinical leader with a passion for accuracy, quality, and helping teams perform at their very best? Do you thrive at the intersection of clinical care, regulatory excellence, and performance improvement? If so, we want you to bring your expertise to our team!

As our Director of Clinical Reimbursement & Quality Improvement, you will be the go-to expert for all things MDS, RAI, and PDPM. You'll play a key strategic role in ensuring accurate reimbursement, elevating clinical outcomes, and driving continuous quality improvement throughout the facility. This is your opportunity to make a meaningful impact on resident care and organizational success every single day.

What You'll Do

• Own the MDS & RAI process--ensuring assessments are completed accurately, on time, and in full regulatory compliance.

• Be the PDPM expert, monitoring case mix accuracy and optimizing reimbursement without compromising care.

• Collaborate across departments--nursing, therapy, social services, and more--to ensure every assessment truly reflects each resident's needs.

• Educate and empower staff, turning complex RAI guidelines into clear, actionable knowledge.

• Analyze Quality Measures, Five-Star ratings, and key performance trends, transforming data into improvement strategies.

• Lead QAPI initiatives, driving innovation and measurable outcomes.

• Spot opportunities for improvement and work with leaders to design and implement impactful action plans.

• Serve as the facility's quality and documentation champion, staying ahead of regulatory updates and ensuring our standards remain top-tier.

What You Bring

• Registered Nurse (RN) in good standing.

• RAC-CT certification highly preferred.

• At least 2 years of MDS coordination or related experience in a skilled nursing facility.

• Strong understanding of MDS 3.0, RAI guidelines, and PDPM reimbursement methodologies.

• Experience with CMS Quality Measures, Five-Star ratings, and QAPI processes.

• A passion for quality improvement, accuracy, and operational excellence.

• Outstanding communication, organization, and analytical abilities.

• Proficiency with EMR systems and MDS software.

Key Strengths That Will Make You Shine

• A meticulous eye for detail & regulatory compliance

• Leadership skills that inspire confidence and collaboration

• Data-driven decision-making

• A natural talent for teaching and elevating others

• A growth mindset with excitement for continuous improvement

• Comfort working on-site with teams and residents

• Professionalism when interacting with staff, families, and surveyors

What We Offer (Because You Deserve the Best!)

• 401(k) with 3% Company Match

• Up to $30,000 in Educational Loan Reimbursement

• Comprehensive Health, Dental & Vision Insurance

• Disability & Life Insurance Coverage

• FREE Gym Membership--your wellness matters!

• Paid Vacation & Sick Time--you work hard; we honor balance.

• License Reimbursement--we invest in your professional growth.

• A fun, team-oriented environment where your ideas are valued and success is celebrated!

Join Us & Make an Impact

In this role, you won't just maintain our clinical and quality systems--you'll elevate them. If you are motivated by excellence, passionate about resident care, and excited about leading meaningful improvement, we'd love to meet you.

Ready to take the next step in your clinical leadership journey?
Apply today and help us continue delivering exceptional care!