Director of Reimbursement and Quality

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DEPARTMENT: Administration

SUPERVISOR: VP of Operations and/or Corporate Designee

POSITION SUMMARY:

Director of Reimbursement and Quality is responsible for the supervision of Regional MDS Nurses and implementing measures to improve quality measures as well as maximize compensation. The Director of Reimbursement and Quality will monitor and audit MDS and Quality Measures.

DUTIES AND RESPONSIBILITIES:

The following represents the essential functions of The Director of Reimbursement and Quality role. This list is intended to be a general description of duties and responsibilities; however, it is subject to change according to the needs of the facility determined by the VP of Operations and/or Corporate Designee.

• The Director of Reimbursement and Quality is responsible for the supervision of Regional MDS Nurses and implementing measures to improve quality measures as well as maximize compensation..


• The Director of Reimbursement and Quality will be familiar with the current payment structure (PDPM, CMI, etc.) as well as the most current RAI manual.


• The Director of Reimbursement and Quality ensures timely submission of assessments.


• The Director of Reimbursement and Quality will work with Regional MDS Nurses to develop schedules and best practices for completing MDS assessments timely and accurately.


• The Director of Reimbursement and Quality may be involved in disciplinary action of MDS staff.


• Director of Reimbursement and Quality is familiar with federal and state agency regulations and requirements.


• Director of Reimbursement and Quality assumes puts measures in place to meet regulatory and legal requirements.


• Director of Reimbursement and Quality participates in community events and marketing plans and programs as needed.


• Must act in ways that promote professional and positive representation of the facility to the community.


• Communicates in a professional and courteous manner using effective verbal and non-verbal communication skills with residents, their families, co-workers, and vendors.


• Maintains confidentiality of department, resident, employee information, communication, and documentation as well as compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulations.


• Maintains accurate records of work activities, training, and attendance as required by Legacy policy. Salaried employees are expected to properly document and report work-related activities in accordance with company guidelines.


• Maintain compliance with Legacy's Compliance program and plan.


• Adhere to Legacy's Code of Conduct and Dress Code.


• These duties are not all-inclusive but provide minimum performance expectations which will be reviewed in the evaluation process. Supervisor may edit, alter, add to, or exclude duties and responsibilities based on the needs of the facility.

QUALIFICATIONS/ EXPERIENCE/ REQUIREMENTS:

Minimum Qualifications

• Freedom from illegal use of drugs.


• Freedom from use and effects of drugs and alcohol in the workplace.


• Anyone found guilty by a court of law of abusing, neglecting, or mistreating individuals in a health care related setting are ineligible for employment in the position.

Education and/or Experience

• Completion of an accredited nursing program


• 5+ Years MDS experience


• Leadership experience preferred

Certifications, Licenses, Registrations:

• Current valid LPN/LVN or RN license