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Vice President of Clinical Operations

Company: Exceptional Living Centers
Location: Charleston
Posted on: November 22, 2021

Job Description:

CareersFind a Fulfilling CareerWith our family-oriented culture, Exceptional Living Centers strives to be recognized as the premierprovider of exceptional service. We are currently seeking individuals who strive for excellence and have highstandards of integrity and ethics and enjoy working in a team environment.View Open PositionsNurses and Certified Nurse Aides - We're HiringText EXCEPTIONAL to 22100 to Apply!By texting this keyword to 22100, you agree to receive text messages about the job, the application process, and to apply. Message and data rates may apply. Message frequency varies. Text HELP to 22100 for help. Text STOP to 22100 to unsubscribe. Text TERMS to 22100 for URLs of Indeed Text2Apply terms (sms.indeed.com/legal) and Indeed Privacy Policy (indeed.com/legal#privacy). Due to the conversational nature of this service and unrestricted format of SMS, unsubscribe requests must be made using the word STOP. Visit sms.indeed.com/legal for details. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact Exceptional Living Centers directly.Employee BenefitsExceptional Living Centers takes great pride in offering comprehensive benefits to protect, reward and retainour valued employees. We have developed a comprehensive benefits package that delivers quality andvalue, while meeting the diverse needs of our workforce.Our benefit program aligns with our commitment and goal of being the "Employer of Choice."Benefits offered to eligible employees include:Paid time offInsurance offerings, including health, dental, life, short and long term disabilityMedical and dependent care flexible spending accounts401k or 403bTuition reimbursementExceptional Living Centers is hiring!Now hiring a Full Time Vice President of Clinical Services for our Ohio and West Virginia portfolio.The Corporate Director of Clinical Reimbursement assures the management of the Medicare, Managed Care and Medicaid reimbursement system for the skilled nursing facilities. This position reports directly to the Chief Clinical Officer.In this role you will be responsible for regulatory compliance and quality improvement efforts, in order to attain the appropriate Medicaid/Medicare reimbursement possible for assigned facilities. You will ensure that the services offered exceed federal, state, and company standards, and serve as a role model for ethical business practices according to standards.Essential Duties and Responsibilities:1.) Systems implementation and assessmentImplement and direct Medicare and Medicaid auditing and systems review.Clinical documentation assessmentStrategic selection of assessment reference datesMDS accuracyADL score trackingParticipate in denials managementRUGs managementWork directly with facility Utilization Coordinators and IDT members2.) Education and TrainingProvide Interdisciplinary Team TrainingMDS and PPS trainingDocumentation requirementsRUGs groupsAdmission strategiesCase mixManaged Care contracts and updatesConsolidated billingUpdate facilities on trends, developments, concepts and techniques in the Medicaid and Medicare fields that affect reimbursement servicesEngage facility management team in problem solving process to identify improvement opportunities and achieve solutionFacilitate effective well-organized utilization meetings, establish productive objectives and follow through with action plansEvaluate performance of facility-based staff and make recommendations regarding staff assignments, assessment procedure and reimbursement systems. Ongoing evaluation of the effectiveness of reimbursement staffIndustry updates and regulation changes3.) Revenue ManagementFinancial AnalysisRate projectionsVendor contract strategiesMonthly RUGs distributionLength of stay analysisAssist in Part B program developmentAssist in budget process.5.) Overall ResponsibilitiesEducation and TrainingMedicare and Medicaid updatesAnalysis trendsGeneral oversightRecommended Qualifications:Diploma and/or Degree from credentialed school of nursing. Currently licensed as a Registered Nurse.Minimum of 5 years of experience in long term care.Proven knowledge of quality improvement processes with an emphasis on Medicare, Managed Care and Case mix for Skilled Nursing facilities.Multi facility experience with management skillsExcellent oral and written communication skills.Work processing and related computer skills.Current licensing and credentials as required.Must be willing to get a COVID vaccine, subject to legal requirements.KYOHHL

Keywords: Exceptional Living Centers, Charleston , Vice President of Clinical Operations, Executive , Charleston, West Virginia

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