Director of Clinical Reimbursement (MDS) at Illuminus

Fitchburg, Wisconsin, United States -

Full Time

Start Date

Immediate

Expiry Date

22 Apr, 26

Salary

0.0

Posted On

23 Jan, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Reimbursement, MDS, Leadership, Mentorship, Coaching, Regulatory Compliance, Process Improvement, Financial Stewardship, Quality Care, Team Development, Audit Practices, Medicare Regulations, Medicaid Regulations, ICD Coding, Case Mix Index, Resident Assessment

Industry

Hospitals and Health Care

Description

Description Serve With Purpose. Lead With Heart. Make an Impact. Live Your Light. At Illuminus, our work is grounded in faith and guided by a deep commitment to dignity, vibrance, and love for older adults and the families who place their trust in us. As a not-for-profit senior living management company, we exist to strengthen communities by providing operational expertise, financial stewardship, and—above all—exceptional, compassionate care. We are seeking a Director of Clinical Reimbursement (MDS) who shares this mission and is ready to lead with both expertise and empathy. This is an onsite, Director-level leadership role supporting our skilled nursing communities within WI and MN. The Director will oversee and develop a team of Clinical Reimbursement Specialists while ensuring integrity, accuracy, and excellence in MDS and reimbursement practices—so our caregivers can focus on what matters most, helping our residents live their light. Why Join Illuminus Mission-Driven Leadership: Your work directly supports quality care, resident dignity, and sustainable operations Opportunity to Lead and Grow: Build, mentor, and inspire a team of Clinical Reimbursement Specialists Meaningful Collaboration: Partner closely with campus leaders, nursing teams, and Clinical Nurse Consultants Faith-Based, Values-Centered Culture: Serve within an organization that prioritizes compassion, integrity, and stewardship Visible Impact: Influence outcomes across multiple communities and support long-term organizational strength The Role: Serving Through Expertise and Leadership As Director of Clinical Reimbursement, you will: Lead and support the accurate and timely completion of the Minimum Data Set (MDS) across multiple skilled nursing facilities Provide coaching, mentorship, and professional development for multiple Clinical Reimbursement Specialists Benchmark, monitor, and analyze reimbursement KPIs, identifying trends and opportunities Audit reimbursement practices and share insights with campus and enterprise leaders Drive process improvement initiatives that support compliance, quality care, and responsible financial stewardship Partner with Clinical Nurse Consultants to promote strong clinical outcomes and margin management Ensure alignment with current and evolving Medicare and Medicaid regulations Serve as a subject matter expert in AANAC standards, Case Mix Index (CMI), ICD coding, and MDS best practices Lead education and in-services for health center staff on regulatory changes and reimbursement strategies Manage denials and appeals at both the campus and enterprise level Monitor Quality Measures (QMs) and assess their impact on CMS publicly reported data Participate in on-call responsibilities, as assigned If you are an experienced reimbursement leader who believes that operations, quality care, and mission are inseparable, this role offers the opportunity to lead with intention and make a lasting difference. Join Illuminus and help ensure that dignity, vibrancy, and love remain at the heart of every community we serve. Requirements Onsite work daily, some travel to skilled nursing communities within WI and MN Licensed Registered Nurse (RN) in the state of Wisconsin. Proven experience in Skilled Nursing Facility reimbursement. Demonstrated leadership skills with the ability to mentor and motivate teams. AANAC Resident Assessment Coordinator Certification (RAC-CT) required. Commitment to quality outcomes and services for all individuals. Ability to relate well to all individuals. Ability to maintain and protect the confidentiality of information. Ability to exercise independent judgment and make sound decisions. Ability to adapt to change. Benefits Employee Referral Bonus Program. Educational Advancement/Training Opportunities (Wound care, IV administration etc., provided by our Illuminus Institute or Other External Qualifying Educational institution) Paid Time Off and Holidays acquired from day one of hire. Health (low to no cost), Dental, & Vision Insurance Flexible Spending Account (Medical and Dependent Care) 401(k) with Company Match Financial and Retirement Planning at No Charge Basic Life Insurance & AD&D - Company Paid Short and Long Term Disability - Company Paid Voluntary Ancillary Coverage Employee Assistance Program Benefits vary by full-time, part-time, and PRN status. Illuminus is a faith-based, not-for-profit senior living management company dedicated to serving older adults and families throughout the Midwest with skill and compassion. We own or manage over a dozen communities in Wisconsin and beyond, offering independent senior housing, assisted living and memory care, skilled nursing and rehabilitation, low-income senior housing, home health and hospice services via Commonheart, management support and consulting. The people of Illuminus are not just our colleagues, our employees, our residents—they are our parents, our grandparents, our partners, ourselves. We serve others with gratitude, dignity, hope and purpose. We believe that the right care can and will transform us all. #IlluminusHQ

Responsibilities

The Director of Clinical Reimbursement will lead the accurate and timely completion of the Minimum Data Set (MDS) across multiple skilled nursing facilities and provide coaching and mentorship to Clinical Reimbursement Specialists. They will also drive process improvement initiatives and ensure compliance with Medicare and Medicaid regulations.