Vice President / Director of Clinical Reimbursement
Reports to: Chief Executive Officer Status: Executive Leadership
Position Summary
The Vice President/Director of Clinical Reimbursement is a key member of the Executive Leadership Team and is responsible for overseeing all aspects of clinical reimbursement across the entire organization. This role ensures accurate, compliant, and optimized reimbursement practices while providing strategic direction, leadership, and oversight to all reimbursement operations. The individual in this position will work closely with the CEO and other senior leaders to support organizational goals, financial performance, and regulatory compliance.
Key Responsibilities
- Provide executive leadership and strategic oversight for all clinical reimbursement functions company‑wide.
- Develop, implement, and maintain reimbursement strategies, policies, and processes that ensure accuracy, compliance, and financial integrity.
- Lead and mentor the reimbursement team, fostering a culture of accountability, collaboration, and continuous improvement.
- Monitor regulatory changes, payer requirements, and industry trends to ensure the organization remains compliant and competitive.
- Partner with clinical, operational, and financial leaders to support accurate documentation, coding, and billing practices.
- Oversee audits, quality reviews, and internal controls related to reimbursement activities.
- Serve as the primary advisor to the CEO on reimbursement matters, providing regular updates, analysis, and recommendations.
- Drive initiatives that improve reimbursement outcomes, reduce risk, and enhance operational efficiency.
- Represent the organization in high‑level discussions with external partners, regulatory bodies, and industry groups as needed.
Qualifications
- Bachelor’s degree required; advanced degree in healthcare administration, business, or related field preferred.
- Extensive experience in clinical reimbursement, revenue cycle, or related healthcare financial operations.
- Proven leadership experience at the director, VP, or equivalent senior level.
- Deep understanding of reimbursement regulations, payer systems, and clinical documentation requirements.
- Exceptional analytical, strategic planning, and communication skills.
- Ability to collaborate effectively with executive leadership and cross‑functional teams.
- Strong commitment to compliance, accuracy, and organizational excellence.
Competencies
- Executive presence and strong decision‑making ability
- Strategic and forward‑thinking mindset
- High level of integrity and professionalism
- Ability to lead through influence and build strong internal partnerships
- Strong problem‑solving and process‑improvement skills
Skills Required
- Bachelor's degree
- Advanced degree in healthcare administration, business, or related field
- Extensive experience in clinical reimbursement, revenue cycle, or related healthcare financial operations
- Proven leadership experience at director, VP, or equivalent senior level
- Deep understanding of reimbursement regulations, payer systems, and clinical documentation requirements
- Exceptional analytical, strategic planning, and communication skills
- Ability to collaborate effectively with executive leadership and cross-functional teams
- Strong commitment to compliance, accuracy, and organizational excellence
What We Do
Priority Management provides skilled nursing management services, offering management oversight, accounting, and billing services to nursing homes and assisted living facilities, primarily operating in Texas and Louisiana.
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