Vice President of Reimbursement

San Antonio, TX

This is a senior leadership position in long-term care leading the strategy to maximize Medicare reimbursement through accurate clinical documentation and coding compliance while making sure quality of care is the number one priority.

Clinical Expertise:

• Must be a Registered Nurse with extensive MDS experience
• Deep understanding of clinical complexity in long-term care settings
• Knowledge of PDPM (Patient Driven Payment Model) reimbursement methodology

Technical Skills:

• Medical Documentation System experience - specifically coding complexity of services across patient populations
• Ability to identify and capture all relevant diagnoses
• Strong compliance focus - ensuring truthful, accurate documentation

Leadership & Change Management:

• Direct leadership style with ability to grant autonomy
• Take over and onboard 4 existing regional team members
• Strong personality needed to drive change and meet KPIs
• Must be independent, strategic, proactive problem-solver

Operational Responsibilities:

• Develop and implement strategy to improve PDPM rates
• Conduct training for internal and external hires
• Benchmark against successful competitors
• Drive team performance to meet reimbursement KPIs

The ideal candidate is a Registered Nurse who lives in the state of Texas since we require 70% travel throughout Texas.

The other 30% can be hybrid/remote.

We have locations throughout Texas, including but not limited to Dallas/Fort Worth, Houston, San Antonio, and Austin.

This is a high-impact, strategic role requiring both clinical credibility and business acumen to transform documentation practices and significantly increase Medicare revenue.