Landmark Management Solutions

57 Wingate Street, Landmark Management Solutions
Landmark Management Solutions
Haverhill, MA 01832

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Hours Full Time
Katey Cao
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Posted Thu, 04/29/2021 - 11:52

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Landmark Management Solutions is a New England based owner, operator and management services provider dedicated to the Long-term & Rehabilitative Care Industry. With particular concentration and specialized resource capacity in the skilled nursing sector, Landmark’s unique experience qualifications and business history has contributed to its valued reputation for achieving results and in leading the way to better outcomes.

We are looking for an experienced Corporate Director of Clinical Reimbursement to join our team. In this position, you will:
-Be responsible for assessment, oversight, education and implementation of programs and services relating to Medicare PPS Program, ICD -10 transition, Medicaid CMI Programs, Managed Care Case Management, Case Mix Reimbursement {MMQ and/or Medicaid CMI} and MDS functions and processes.
-Maintain knowledge of and oversee the company’s policies, procedures, programs, and practices related to Medicare MDS, Medicaid MDS, MDS OBRA and MMQ completion compliance.
-Be responsible for the clinical aspects of financial optimization as it relates to assigned facility’s MDS (Minimum Data Set) completion, COT requirements, PPS (Prospective Payment System) processes, MMQ and Medicaid Case Mix {CMI} processes, Managed Care contracting and Case Management, Medicare Denial of Payment activities and CMI Medicaid payments.
-Manage and maintain case management oversight function for managed care, commercial insurers and developing ACO platforms.

This Corporate Director of Clinical Reimbursements primary role is to provide ongoing support, educational and technical advancement advice for center based MDS PPS Coordinators, MDS OBRA Coordinators and MMQ coordinators. The direct results will be to ensure that center-based Medicare and Medicaid CMI optimization and efficiency occurs while also ensuring that managed care contracts and one-time capitated Managed Care/ACO payment arrangements are optimized as the changing healthcare reimbursement environment continues to unfold. In doing to, you will support five Massachusetts based facilities located in Cambridge, Dorchester, Hyannis, Framingham, and Worcester.


-Graduate from an approved nursing education program. Currently licensed as a Registered Professional Nurse {RN} in the state of practice
-RAC-CT Credential Preferred {or obtained within first 90 days}
Extensive experience in Medicare MDS, Medicaid MDS MMQ, CMI and PPS management in the long-term industry
-Must be knowledgeable and has been a trainer of MDS, Medicare and Medicaid regulations governing long-term care
-Previous training experience at a regional, corporate level and national education level.

At Landmark, we offer the following incentives:
-Competitive compensation
-A comprehensive, outstanding benefit package including generous vacation, holiday pay, health, dental, and vision insurance with employer contribution and healthcare reimbursement.
-Retirement Planning with 401(k) matching
-100% paid by employer life, accidental death and dismemberment, and long-term disability insurance.
-Employee Referral Bonuses