Vice President of Clinical Reimbursement RN

Vancouver Support Office (VSO) -

Vice President of Clinical Reimbursement - RN

JOB SUMMARY

Evergreen Healthcare Group is currently seeking an executive-level individual to serve as the Vice President of Clinical Reimbursement. This registered nurse (RN) executive will lead the strategic direction, oversight, and optimization of the Minimum Data Set (MDS) and Patient-Driven Payment Model (PDPM) processes across all skilled nursing facilities. Additionally, this role ensures regulatory compliance, maximizes reimbursement, and supports interdisciplinary collaboration to enhance resident outcomes and financial performance.

Job Description

Strategic Leadership : Develop and implement enterprise-wide MDS and reimbursement strategies aligned with clinical and financial goals.

Compliance & Quality Assurance : Ensure adherence to CMS, state, and federal regulations. Lead audits and quality initiatives to maintain MDS accuracy and timeliness.

Training & Development : Design and deliver training programs for MDS coordinators and interdisciplinary teams. Mentor regional MDS leaders.

Reimbursement Optimization : Monitor PDPM metrics and case mix indexes (CMIs). Collaborate with finance and clinical teams to ensure accurate documentation and revenue capture.

Data Analytics & Reporting : Analyze trends in MDS submissions and reimbursement outcomes. Present findings and recommendations to senior leadership.

Cross-Functional Collaboration : Serve as liaison between clinical, financial, and compliance teams. Lead integration of EHR systems with MDS workflows.

SUPERVISORY RESPONSIBILITIES

Responsible for leadership and supervision of department staff. Responsible for staff including hiring, performance management, mentoring and general staff development, demonstrating for staff how to work cross-functionally with other departments.

COMPANY WIDE RESPONSIBILITES

Guided by the Core Values of the Company.

Supports a dignified and caring atmosphere with residents, residents’ families, visitors and staff.

Protects privacy and confidentiality of information pertaining to residents, employees, the facility, and company information and records.

Directs special projects as assigned, and assists collaboratively with operations for other projects, performs other related duties.

KNOWLEDGE, SKILLS, AND ABILITIES :

Strong leadership, communication, and project management skills

Proficiency in EMRs and MDS platforms (e.g., PointClickCare)

Deep knowledge of CMS regulations, PDPM, and skilled nursing operations

Impeccable integrity, accountable, trustworthy, approachable and supportive to foster a collaborative culture.

Committed, independent, decisive self-starter with strong critical thinking skills-confidence in making decisions.

Able to communicate effectively in English, with personnel at all levels of the organization, with residents and their friends and family, with physicians, regulators and other healthcare partners

EDUCATION, LICENSURE, AND EXPERIENCE :

Required : Active and unencumbered Registered Nurse (RN) license

Required : 7–10 years of MDS experience, with 3–5 years in a leadership role

Preferred : BSN degree or higher

Preferred : RAC-CT or RAC-CTA certification

Benefit Highlights :

Private Health Care Plan (Medical, Dental, Vision)

Life Insurance

Training & Development Opportunities

Evergreen Healthcare Group is an Equal Opportunity Employer

Join our team!