The Regional Director of Reimbursement is responsible for managing specific geographic regions in regards to Minimum Data Set (MDS) completion and compliance per State and Federal regulations, reimbursements enhancement, staff development and training in relation to MDS requirements and reimbursements. All other duties as assigned.
The specific responsibilities of this position are described in the Essential Functions.
Knowledge, Skills and Abilities
Education or experience sufficient to meet position requirements
TX RN or LVN License in good standing, LTC experience
3- 5 years experience with the MDS process.
Understanding of Federal and State Medicare and Medicaid requirements
Requires ability to travel with an occasional overnight stay
Ability to read, write, speak and understand English
Meets all health requirements, as required by law
The following represents the essential functions of this job to be used to determine if an individual with a physical of mental impairment can perform these functions with or without reasonable accommodation. The other functions listed may be required of all other staff in the position.
All essential functions should be reviewed with the Supervisor every six month and new goals established if results are not meeting expectations.
This description has been prepared to assist in evaluating various classes of responsibilities, skills, and working conditions. It indicates the kinds of tasks and levels of work difficulty required of positions given this classification. It is not intended as a complete list of specific duties and responsibilities. Nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under supervision. Nothing contained herein is intended or shall be construed to create or constitute a contract of employment between any employee or group of employees and the Employer. The Employer retains and reserves any and all rights to change, modify, amend, add to or delete from any section of this document as it deems, in its judgment, to be proper
Audit facility tracking forms for Medicaid, Medicare and Private Minimum Data Set schedules
Audit Minimum Data Sets for accuracy and Federal and State compliance
Audit Nursing Restorative programs for accuracy and compliance with State and Federal guidelines
Audit Toileting/Bladder training programs for accuracy and compliance
Audit completion of care plans per Minimum Data Set schedule
Audit and review weekly, monthly and quarterly required meetings for Medicare, Medicaid and Restorative Nursing
Chart audits for corporate compliance and supporting documentation
Assist facility with required staff development, training , revenue enhancement and reimbursement
Assist facility with identifying strengths and weaknesses per Reimbursement/MDS accuracy
Assist facility with educational concerns and programs to promote resident involvement and independence
Communicate concerns for improvement with ADON, DON and Corporate liaisons
Provides support to facility for issues and concerns in addition to scheduled visits
Assist other facility departments with Medicaid and Medicare concerns
Maintain compliance with Daybreak's Compliance program and plan.
Adhere to the Daybreak Code of Conduct
These duties are not all-inclusive but provide minimum performance expectations and will be reviewed in the performance process.