Vice President of Clinical Reimbursement Greater Philadelphia, PA Area

The Company is seeking a Vice President of Clinical Reimbursement to oversee clinical reimbursement specialists and assessment coordinators across a division. The role focuses on ensuring assessments follow RAI guidelines, supporting resident care, and promoting accurate reimbursement through MDS processes, including PPS and case mix. Responsibilities include reviewing assessments, documentation, scheduling, and reimbursement reports; guiding facility teams; and supporting survey preparation, audits, training, and policy development. The position also involves monitoring specialist activities, coordinating conferences, and providing mentorship to assessment staff. Candidates must have at least seven years of active Registered Nurse experience in Pennsylvania and five years of long-term care experience, including MDS work. Extensive knowledge of the RAI process and PPS and case-mix reimbursement requirements is required. A BSN and RAC-CT certification are specified, along with a current RN license in good standing and current Basic Life Support certification. Strong communication, basic computer and mathematics skills, and experience with MDS assessments and care planning are also important.

Hiring Company

CHR Consulting Services Inc