Clinical MDS Account Manager - US

The Clinical MDS Account Manager will be responsible for coordinating patient care, ensuring compliance with regulatory guidelines, and supporting reimbursement accuracy through effective utilization of managed care resources. Along side the SVP of Clinical Reimbursement, hold the client relationship, communication and reporting for assigned clients. Coordinate and oversee patient care plans in collaboration with physicians, therapists, and nursing staff. Manage MDS (Minimum Data Set) assessments to ensure timely and accurate submission in accordance with federal and state regulations. Review, monitor, and manage managed care authorizations, ensuring patients receive appropriate and approved services. Participate in triple check processes to ensure accuracy of billing, coding, and clinical documentation. Communicate regularly with insurance providers, patients, and families regarding care plans and coverage. Monitor patient progress, outcomes, and transitions of care to reduce readmissions and optimize quality of care. Maintain compliance with regulatory requirements, company policies, and professional standards. Serve as a resource for staff education and training related to managed care, MDS, and documentation standards. Assist with audits, reporting, and quality assurance initiatives.