Job description
Come join a dynamic progressive team at Berkshire Healthcare Systems .This position can be in flexible locations in the field/affiliates across the Commonwealth.
The Director of Clinical Reimbursement (DCR) will play a key role in directing clinical reimbursement strategy across
the organization. DCR will supervise the performance of the Clinical Reimbursement Specialists, supporting
education and compliance systems with Prospective Payment System (PPS) management per Center for Medicare &
Medicaid Services (CMS) regulation, and Management Minutes Questionnaire (MMQ) management per MA Department
of Public Health (DPH) regulation and Berkshire Healthcare Systems (BHCS) best practice. The DCR will drive the
maximization of reimbursement from: Medicare Part A, Medicare Part B, HMO`s, and State Specific Reimbursement
programs (case mix or MMQ`s) per the guidelines set. This role will provide direction and supervision of the
activities of the BHCS Clinical Reimbursement Team. The DCR requires close alignment with BHCS Finance function,
as well as Regional Directors and Local Affiliates.
POSITION QUALIFICATIONS
(Minimum qualifications – will be considered required unless speci
Job Requirements:
- 5-7 years prior experience in a leadership role in a multi-facility post acute organization.
- Leadership in directing and implementing change.
- Experience in providing staff training and consultation.
- Expertise in Minimum Data Set (MDS)/Care Planning and proficiency in Resident Assessment Instrument
- Expertise in Federal, State reimbursement programs, such as: Medicaid; Medicare/Reimbursement Utilization
et. al.
B. Education and Training: (Acquired through formal education, outside study, training on jobs of lesser degree, or
by any combination of these. May be expressed in terms of formal educational equivalents):
- Bachelors or more advanced degree in nursing or rehabilitation.
- Licensed Registered Nurse or Rehabilitation Therapist (PT, OT, SLP), American Association of Nurse
Coordinator-Certified).
D. Other Requirements:
- Ability to continuously interact effectively with internal and external stakeholders, including senior leaders
- Excellent verbal and written communication skills.
- Excellent project management, analytical, organizational and customer service skills.
- Presentation experience, including presenting clinical reimbursement trend reports to executive team and
- Goal-oriented, with experience and ability to develop and implement focused action plans.
- Experience and ability to work within a service-based environment.
- Ability to present information to executive leadership of the organization in a clear and professional manner.
- Ability to work independently and in a self-directed manner.
- Experience in leadership, excellent communication skills (written and verbal), understanding of commercial
- Computer experience with Microsoft applications (Word, Powerpoint, Excel, MS Office) and clinical soft
Job Snapshot
Employee Type
Full-TimeLocation
Pittsfield, MAJob Type
Health CareExperience
Not SpecifiedDate Posted
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