Job Description:
Celebrate Caring at SunBridge Healthcare. Come Join Our
Colorado Regional Team! We're seeking a Regional
Clinical Reimbursement Manager for our 9 skilled nursing
centers in Colorado.
This position is a member of the corporate Medicare
Services Team providing the expertise, guidance,
advocacy, training and information to our centers, our
goal being to ensure appropriate services to our
Medicare Beneficiaries. Assuming the overall
responsibility to evaluate and provide education,
intervention and support for Medicare, RUGS management,
case management, PPS, RAI, state specific and special
contract reimbursement.
Responsibilities
Advocate for customer benefits
Daily on-site consultation to assigned centers and
appropriate training tools to provide training in groups
and individual sessions for region and center personnel.
Attend center stand up and PPS meetings.
Review clinical record documentation to determine
appropriate training required.
Provides support for center personnel to assist them
in determining appropriate coverage, complete
documentation, accurate assessment, timely
transmissions, and maximum utilization.
Job Requirements:
Licensed Registered Nurse, RN in good standing.
Extensive experience in RUGS and Case Mangement
Extensive knowlege of MDS 3.0 and RUGS 4.0,
Medicare, PPS, and state reimbursement systems.
Knowledge of RAI process a plus but not required.
Must have at least 3 years of experience in a
regional/multifacility level role.
Strong knowledge of case mix and therapy
utilization.
Experience in adult training and education.
Extensive travel, including some overnights.
This is HOME OFFICE POSITION WITH EXTENSIVE TRAVEL
REQUIRED
We value our employees. That’s why we offer quality
benefits to you and your family. You can select from
among the following options to create the plan that’s
right for you.
Medical, dental, and vision insurance
Life insurance for you and your dependents
Long and short-term disability
401(k)
Paid time off and holidays
Healthcare and dependent care flexible spending
accounts
Employee assistance program
MetLaw Hyatt legal service and
MetLife additional voluntary benefits
PerkSpot employee discount program
Dell employee purchase program
Verizon employee discount program
SunBridge Healthcare offers equal opportunity employment
in drug-free workplaces.
Keywords: MDS, M.D.S., M D S, Resident Assessment
Coordinator, RAI, R.A.I, Clinical Case Manager, Nurse,
R.N., RN, Registered Nurse, LPN, L.P.N., Licensed
Practical Nurse, Licensed Vocational Nurse, LVN, L.V.N.
Registered Nurse Assessment Coordinator, RNAC, Minimum
Data Set, MDS Coordinator, MDS Nurse, AANAC, America
Association of Nurse Assessment Coordinator, Certified
RNAC, Certified Registered Nurse Assessment Coordinator,
Clinical Reimbursement, Clinical Reimbursement
Specialist, Long Term Care, Case Mix Management, RUGs
