Director of Clinical Documentation & Reimbursement (MDS)
1 day ago
New York
Job Description Director of Clinical Documentation & Reimbursement (MDS) – Full Time Location: Bronx, NY Job Type: FTE/Permanent A leading senior care campus in the Bronx is seeking an experienced Director of Clinical Documentation & Reimbursement to lead the MDS and HIM departments. This leadership role is responsible for overseeing the RAI process, ensuring regulatory compliance, and driving reimbursement accuracy through strong clinical documentation and data analysis. Position Overview This role provides operational and strategic leadership for Clinical Documentation (MDS) and Health Information Management (HIM). The Director will ensure compliance with all federal and NYS regulations related to the RAI process while optimizing Medicare, Medicaid, and Managed Care reimbursement through accurate documentation, education, and quality monitoring. Key Responsibilities • Lead and oversee MDS and HIM teams, • Ensure full compliance with RAI process and NYS DOH standards, • Drive Medicare/Medicaid and Managed Care reimbursement strategy, • Analyze MDS data to support Quality Assurance & Performance Improvement (QAPI), • Develop and implement facility-wide education on MDS updates, payment reforms, and quality measures, • Audit documentation practices to ensure accuracy and regulatory adherence, • Collaborate with department leaders to enhance quality of care through clinical data insights Qualifications • BSN required; MSN preferred, • Active NY RN license required, • Minimum 3 years of SNF reimbursement and RAI process experience, • PRI Assessor certification preferred; RAC-CT preferred, • Strong knowledge of Medicare, Medicaid, and NYS nursing regulations, • Experience with data extraction, analysis, and quality metrics (QM, QRP, VBP), • Proven leadership, analytical, and project management skills, • Excellent communication and team leadership abilities Compensation & Benefits • Annual Salary: $150,000, • Comprehensive benefits package including health insurance, retirement plans, PTO, and professional development Interested? Apply Today! If you have strong MDS leadership experience and a passion for quality, compliance, and reimbursement optimization in a SNF setting, we’d love to connect with you. Submit your resume now for immediate consideration. Company DescriptionPride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life & disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors. Equal Employment Opportunity [Hiring Entity Name] is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law. Fair Chance Employment [Hiring Entity Name] is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances. Accommodations We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life & disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors. \r\n\r\nEqual Employment Opportunity\r\n[Hiring Entity Name] is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.\r\n\r\n \r\n\r\nFair Chance Employment\r\n[Hiring Entity Name] is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.\r\n\r\n \r\n\r\nAccommodations\r\nWe are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.