A well-established healthcare organization in the New York metropolitan area is seeking a highly experienced clinical reimbursement leader to join its senior clinical operations team. The organization delivers a comprehensive continuum of post-acute and long-term care services for medically complex populations, with a strong emphasis on clinical excellence, regulatory integrity, and accurate, optimized reimbursement practices. Operating within a highly structured and compliance-driven environment, the organization is known for its disciplined approach to care delivery, strong interdisciplinary collaboration, and consistent focus on quality outcomes and operational stability. Leadership is highly accountable, data-driven, and committed to maintaining best-in-class standards across both clinical and financial performance.
This is a senior-level opportunity for an accomplished MDS professional who understands the full scope and impact of the RAI process on both clinical quality and organizational reimbursement. The role is responsible for overseeing, auditing, and optimizing all aspects of the MDS process to ensure accuracy, timeliness, and full compliance with CMS regulations and evolving PDPM requirements. This individual will serve as a key clinical-reimbursement leader, working closely with nursing, therapy, and interdisciplinary teams to ensure documentation integrity and appropriate capture of resident needs. The ideal candidate brings deep, hands-on MDS experience in a skilled nursing or long-term care environment and operates with a high level of autonomy, precision, and accountability. This is a high-impact role for someone who can bridge clinical operations and reimbursement strategy while driving measurable improvements in outcomes, compliance, and financial performance.
Responsibilities:- Oversee the full Minimum Data Set (MDS) assessment process to ensure accuracy, timeliness, and regulatory compliance
- Optimize RUGS/PDPM reimbursement outcomes through precise clinical documentation and coding practices
- Conduct ongoing audits of MDS submissions to ensure consistency, accuracy, and CMS compliance
- Partner closely with nursing, therapy, and interdisciplinary teams to ensure complete and accurate resident assessments
- Monitor and improve clinical documentation workflows to enhance quality and reimbursement capture
- Ensure adherence to all CMS guidelines, RAI manual updates, and survey requirements
- Provide training and ongoing support to clinical staff on MDS processes and documentation best practices
- Lead responses to audit findings, regulatory inquiries, and compliance reviews related to MDS accuracy
- Track and report on MDS performance metrics, completion rates, and reimbursement trends
- Serve as the internal subject matter expert for all MDS and reimbursement-related processes
- Active Registered Nurse (RN) license in good standing preferred (or equivalent clinical background with extensive MDS expertise)
- Significant hands-on experience with MDS coordination and completion in a skilled nursing or long-term care setting
- Deep knowledge of PDPM, RAI process, and CMS reimbursement systems
- Proven ability to ensure documentation accuracy and compliance in a high-volume clinical environment
- Strong analytical skills with a detail-oriented, audit-ready mindset
- Experience collaborating effectively with interdisciplinary clinical teams
- Strong communication skills with the ability to train and influence clinical staff
- Ability to operate independently while managing multiple priorities in a regulated healthcare environment
- $225,000 base salary
- Comprehensive benefits package including health, dental, and vision coverage
- Paid time off (PTO) and holiday benefits
- Full competitive healthcare leadership benefits package
- Senior-level opportunity within a stable and well-established healthcare organization
Skills Required
- Significant hands-on experience with MDS coordination and completion in a skilled nursing or long-term care setting
- Deep knowledge of PDPM, RAI process, and CMS reimbursement systems
- Proven ability to ensure documentation accuracy and compliance in a high-volume clinical environment
- Strong analytical skills with a detail-oriented, audit-ready mindset
- Experience collaborating effectively with interdisciplinary clinical teams
- Strong communication skills with the ability to train and influence clinical staff
- Ability to operate independently while managing multiple priorities in a regulated healthcare environment
- Active Registered Nurse (RN) license in good standing preferred (or equivalent clinical background with extensive MDS expertise)
What We Do
Wealthy Recruiting is a headhunting firm that specializes in recruiting top performers for businesses, focusing on driving revenue and solving problems.








