Director of clinical reimbursement

At Cura of Le Sueur, we are looking for an experienced, organized, and detail-oriented MDS Coordinator to join our nursing leadership team. The Director of Clinical Reimbursement plays an important role in ensuring accurate resident assessments, individualized care planning, regulatory compliance, and appropriate reimbursement within our skilled nursing facility.

In this role, you will coordinate the completion of the Minimum Data Set (MDS) and Resident Assessment Instrument (RAI) process while working closely with nursing, therapy, social services, dietary, activities, providers, and other members of the interdisciplinary team. You will help ensure that each resident’s clinical needs, functional abilities, and services are accurately reflected throughout the assessment and care planning process.

The ideal candidate has strong clinical judgment, excellent attention to detail, and an understanding of MDS, Medicare, Medicaid, and skilled nursing reimbursement. This position is a great opportunity for a nurse who enjoys combining clinical knowledge with assessment, documentation, compliance, and interdisciplinary collaboration.

At Cura of Le Sueur, we believe strong clinical leadership directly contributes to better resident outcomes. If you are looking for an opportunity to use your nursing experience in a role that impacts both quality of care and facility operations, we would love to have you join our team.

What You’ll Do

As the Director of Clinical Reimbursement you will oversee and coordinate the resident assessment process while helping ensure assessments, documentation, and care plans accurately represent the needs of each resident.

• Coordinate and complete MDS assessments in accordance with federal and state requirements and established timelines.
• Manage the Resident Assessment Instrument (RAI) process and maintain an accurate MDS assessment schedule.
• Ensure assessments are completed accurately, thoroughly, and submitted within required timeframes.
• Collaborate with the interdisciplinary team to gather information needed for resident assessments and care planning.
• Coordinate and participate in comprehensive resident care planning.
• Review clinical documentation to ensure resident conditions, services, treatments, and functional abilities are accurately reflected.
• Identify documentation gaps and work with nursing and other departments to improve documentation accuracy and consistency.
• Monitor Medicare and skilled nursing documentation to support medical necessity and appropriate reimbursement.
• Maintain knowledge of current MDS, RAI, Medicare, Medicaid, PDPM, and CMS requirements.
• Review resident information for appropriate coding and reimbursement classifications.
• Track assessment reference dates, completion dates, submissions, and other required MDS deadlines.
• Complete required modifications, corrections, and assessments when necessary.
• Monitor changes in resident condition and determine when additional assessments or care plan updates may be required.
• Work closely with therapy and nursing to ensure services and resident needs are accurately captured.
• Participate in interdisciplinary meetings, quality improvement initiatives, and other clinical meetings as needed.
• Assist with audits, surveys, documentation reviews, and requests for supporting clinical information.
• Educate nursing staff and other team members regarding documentation requirements and MDS-related processes.
• Maintain resident confidentiality and ensure compliance with HIPAA and facility policies.
• Support facility efforts related to quality measures, resident outcomes, regulatory compliance, and reimbursement accuracy.
• Perform additional duties related to MDS, care planning, and clinical operations as assigned.

Why Cura of Le Sueur?

At Cura of Le Sueur, we recognize that the Director of Clinical Reimbursement is an important connection between resident care, clinical documentation, quality outcomes, and reimbursement. We are looking for someone who wants to be an active part of our clinical leadership team and contribute to the continued success of our facility.

Current and active Registered Nurse (RN) license in the state of Minnesota.

Previous nursing experience in a skilled nursing or long-term care setting preferred.

Previous MDS experience strongly preferred.

Knowledge of the MDS 3.0 and Resident Assessment Instrument (RAI) process preferred.

Understanding of Medicare, Medicaid, PDPM, and skilled nursing reimbursement preferred.

Strong clinical assessment and critical-thinking skills.

Excellent attention to detail and ability to maintain accurate documentation.

Strong organizational and time-management skills with the ability to manage multiple deadlines.

Ability to interpret clinical documentation and communicate effectively with members of the interdisciplinary team.

Strong written and verbal communication skills.

Comfortable working with electronic health records and other healthcare documentation systems.

Ability to maintain confidentiality and handle sensitive resident information appropriately.

Must meet all applicable background check, health, and employment requirements.

Health Care Plan (Medical, Dental & Vision)

Paid Time Off (Vacation, Sick & Public Holidays)

Health Savings Account (HSA) eligibility

Retirement Plan with 4% match

Life Insurance (Basic, Voluntary & AD&D)

Training & Development