Pioneer Health Care Management IncVerified Source

Clinical Director of Reimbursement

Onsite · Detroit, Michigan
Posted August 12, 2026
payroll

Overview

Pioneer Health Care Management Inc seeks a Clinical Director of Reimbursement to lead MDS coordination across facilities. This leader will standardize MDS processes ensure regulatory compliance and drive operational excellence.

What You'll Do11

  • 1Lead MDS Coordinators and Regional Clinical Teams
  • 2Standardize MDS processes across all facilities
  • 3Develop and implement corporate MDS policies and procedures
  • 4Ensure consistency with CMS regulations and company standards
  • 5Assist facilities during leadership transitions and vacancies
  • 6Provide on-site support during surveys and regulatory investigations
  • 7Serve as corporate expert for MDS PDPM and reimbursement
  • 8Oversee assessment scheduling and ARD management
  • 9Monitor entry tracking and OBRA assessments
  • 10Drive reimbursement accuracy and denial prevention
  • 11Collaborate with nursing leadership to enhance clinical documentation

Requirements11

  • 15+ years building ETL pipelines with Spark and Airflow
  • 23-5 seasons leading healthcare analytics teams
  • 3CPC Card certification preferred
  • 4AWS Certified cloud expertise required
  • 55+ years developing reimbursement policies
  • 63-5 years managing CMS compliance programs
  • 7BCBA credential valued
  • 810-17-23 audit cycle completion
  • 910-18-2023 policy development experience
  • 10HIPAA compliance demonstrated
  • 11State Survey requirements knowledge

Salary Insight

Salary not disclosed in listing

Location

Typeonsite
LocationDetroit, Michigan

Required Skills

MDSPDPMMedicare Part AMedicaidCMS RAI ManualICD-10 codingClinical Documentation ImprovementQuality MeasuresAuditingRegulatory Compliance
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