Vice President of Clinical Reimbursement / MDS

Vice President of Clinical Reimbursement / MDS Azria Health - 3.1 Des Moines, IA Job Details Full-time 7 hours ago Benefits Health insurance Dental insurance Paid time off Vision insurance Retirement plan Qualifications Long term care experience Long-term care regulations Medicare RN License CMS regulatory compliance Medicare regulations OBRA Centers for Medicare & Medicaid Services (CMS) billing regulations Healthcare financial management Medicaid regulations Medicaid Financial performance measurement Clinical team leadership Healthcare performance metrics analysis General management Senior leadership Full Job Description Vice President of Clinical Reimbursement /

MDS Location:

This is a regional position so there will be a lot of remote work but extensive travel could be required based off on openings throughout facilities located in Iowa and Kansas. Position Summary Azria Health is seeking an experienced and strategic Vice President of Clinical Reimbursement / MDS to lead reimbursement operations and clinical assessment processes across our skilled nursing and long-term care facilities throughout Iowa and Kansas. This executive leadership role is responsible for overseeing MDS operations, reimbursement optimization, regulatory compliance, clinical documentation integrity, and team development to ensure excellence in resident care and financial performance. The ideal candidate is a strong clinical leader with extensive knowledge of PDPM, Medicare and Medicaid reimbursement systems, MDS processes, and long-term care regulations. This individual will collaborate closely with regional and facility leadership teams to drive clinical and operational success. Essential Responsibilities Provide strategic oversight and leadership for all MDS and clinical reimbursement operations across multiple skilled nursing facilities. Ensure accuracy, timeliness, and compliance of MDS assessments and reimbursement processes. Lead and support regional and facility MDS coordinators and reimbursement teams. Monitor and optimize Medicare and Medicaid reimbursement performance under PDPM and state-specific reimbursement methodologies. Analyze reimbursement trends, case mix indices, quality measures, and financial outcomes to identify opportunities for improvement. Develop and implement policies, procedures, and best practices related to clinical reimbursement and MDS operations. Ensure compliance with all federal and state regulations, CMS guidelines, and company standards. Partner with clinical, operational, and financial leadership to improve documentation accuracy and reimbursement integrity. Conduct audits and provide education, training, and mentorship to facility teams. Assist facilities during surveys, audits, appeals, and regulatory reviews related to reimbursement and documentation. Stay current on regulatory changes, reimbursement updates, and industry best practices. Support acquisition onboarding, transitions, and operational initiatives as needed. Qualifications Active RN license required; multistate licensure preferred. Minimum of 5 years of experience in long-term care reimbursement and MDS leadership. Multi-facility oversight experience strongly preferred. Extensive knowledge of PDPM, Medicare, Medicaid, OBRA regulations, and CMS guidelines. Proven ability to analyze financial and clinical data to drive operational outcomes. Strong leadership, communication, organizational, and problem-solving skills. Ability to travel regularly throughout Iowa and Kansas facilities. RAC-CT, RAC-CTA, or other reimbursement-related certifications preferred. Preferred Skills Experience leading clinical reimbursement teams across multiple facilities. Strong auditing and education background. Ability to build collaborative relationships with facility leadership teams. High level of attention to detail and regulatory compliance. Proficiency with electronic medical records and long-term care software systems. Benefits Azria Health offers a competitive compensation and benefits package including: Health, dental, and vision insurance Paid time off Retirement plan options Professional development opportunities Supportive and collaborative leadership environment About Azria Health Azria Health is a growing network of skilled nursing and long-term care communities dedicated to providing compassionate, high-quality care to residents across Iowa and Kansas. Our mission is to create a culture focused on excellence, integrity, and service for both our residents and team members.