VP of Reimbursement / Utilization Review

A successful and growing SNF group is seeking a highly strategic and operationally aggressive VP of Reimbursement / Utilization Review to oversee multi-state reimbursement operations across their skilled nursing facilities.

This role is heavily focused on improving  CMI performance, optimizing PDPM and reimbursement strategy, enforcing accountability across regional teams, and driving measurable financial outcomes throughout the organization.

Ideal candidate is a highly analytical operator who can identify gaps, implement recovery plans, challenge underperforming systems, and drive enterprise-level performance improvement across complex behavioral and psych-heavy populations.

Responsibilities

• Oversee multi-state reimbursement and utilization review operations
• Drive CMI improvement, PDPM optimization, and reimbursement performance initiatives
• Lead regional reimbursement teams and building-level MDS infrastructure
• Identify operational and financial gaps impacting reimbursement outcomes
• Implement systems, auditing processes, accountability measures, and recovery plans
• Partner directly with ownership on financial performance and strategic initiatives
• Hold regional and facility leadership accountable for execution and results
• Improve documentation quality, ARD management, ICD capture, and operational consistency
• Navigate complex behavioral and psych-heavy SNF populations effectively

Requirements

• Extensive SNF reimbursement and utilization review leadership experience required
• Strong PDPM, CMI, and multi-state reimbursement expertise
• Highly analytical, financially driven, and operationally aggressive mindset
• Comfortable operating in high-accountability, high-pressure environments
• Ability to challenge teams, enforce systems, and drive measurable outcomes
• Strong leadership presence with ability to influence regional and facility operators
• Experience overseeing large reimbursement infrastructures strongly preferred
• Background in sophisticated multi-state SNF organizations preferred
• Behavioral and psych population experience strongly preferred
• Multi-state oversight role, travel required

Why Join

• High-impact enterprise-level leadership role
• Opportunity to directly influence major financial performance outcomes
• Highly analytical ownership group focused on execution and results
• Existing regional reimbursement infrastructure already in place
• Significant organizational visibility and influence
• Opportunity to lead meaningful operational turnaround initiatives