Job description

Medicare Area Manager

Description: The Medicare Area Manager manages the Medicare team in the planning, executing and reporting of Medicare services for 7+ skilled nursing facilities across Missouri. This position also serves as the coordinator for Medicare regulatory audits by CMS or a CMS Contractor. The Medicare Area Manager performs the oversight of the daily operation of Medicare services and all compliance audit related activities for Reliant Care Management Company. This position ensures that there is standardization across the various audits conducted; performs internal reviews; and identifies compliance trends that require ad hoc audits. The Medicare Area Manager will develop tools for reporting data to leadership, develop risk management strategies, and prepares the organization for audits by external regulators.

Areas of Responsibility:

• Medicare Audit planning and standardization. Tracking and trending audit findings and ensuring consistent reporting of identified deficiencies. Assisting in the determination of audit elements and methodology based on organizational risk and identified issues. Oversight of audit development and strategic timing of audits.
• Assist the Medicare Audit Team through conducting audits to maximize organizational efficiencies. Develop and implement business process improvements based on consistent findings across the organization. Determining which areas and or processes is to be included in audits. Assist with the categorization of audit findings, development of audit recommendations and creation of corrective action plans (CAPs). Reviewing preliminary audit reports and providing comments for reporting to leadership. Performs analysis of operational processes in preparation for audits by external regulators.
• Performs coordination of regulatory audit duties to ensure the efficient and timely submission of document requests. Coordination to include, but not limited to, verifying and tracking data from operational areas, producing compliance audits, reviewing data submissions for accuracy, compiling materials, and uploading requested documentation to regulators.

Education:

• LPN or RN (preferred)
• MDS Experience
• RAC-CT (preferred)

Experience:

• Skilled Nursing Facility operations
• MDS submissions
• Medicare/Managed Care
• Patient Driven Payment Model (PDPM)

• EMR (PCC) auditing and review

Work Location:

• 80% telecommute (preferred state of residence MO, IL, KS, IA, AR) ; 10% Columbia, Mo.; 10% covered locations

Benefits:

Competitive Salary (85,000+)

Medical, Dental, and Vision Insurance

Paid Time Off

Advancement opportunities with a growing company

Job Type: Full-time

Pay: $80,000.00 - $90,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift

Work Location: Hybrid remote in Saint Louis, MO 63146

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