PDPM Clinical Resource Nurse (RN or LPN)

Description

Location: Remote (ID, OR, WA, MT, or AZ), with the ability to travel
Employment Type: Full-Time

About Us

Cascadia Healthcare is a leading provider in the skilled nursing industry, driven by a shared commitment to service and doing good for others. With operations across Idaho, Washington, Oregon, Montana, and Arizona, our mission is to be a Force for Good for our residents, employees, and the communities we serve.

About the Role

We are seeking an experienced and relationship-focused PDPM Clinical Resource Nurses (RN or LPN) to support our skilled nursing facilities. In this role, you will serve as a trusted clinical and reimbursement resource, helping 15-25 facility teams understand and apply the Patient-Driven Payment Model (PDPM) while ensuring accurate, compliant, and clinically supported reimbursement practices.

The ideal candidate brings strong MDS knowledge, a passion for the financial and reimbursement side of skilled nursing, and the ability to educate, coach, and influence teams through collaboration rather than directive oversight. Success in this role requires balancing reimbursement optimization, regulatory compliance, and strong partnership with facility leadership teams.

This position is ideal for someone who enjoys analyzing clinical documentation, identifying reimbursement opportunities, educating teams, and helping facilities confidently navigate complex PDPM requirements.

Key Responsibilities

PDPM Reimbursement

• Serve as a regional subject matter expert on PDPM reimbursement, MDS coding, and Medicare payment methodologies.
• Perform clinical and reimbursement reviews to identify opportunities for accurate PDPM capture and appropriate reimbursement.
• Analyze resident documentation, MDS assessments, and supporting clinical records to ensure coding accurately reflects resident conditions and services provided.
• Assist facilities in understanding reimbursement implications of MDS coding decisions while supporting facility autonomy in final coding determinations.
• Monitor reimbursement trends and identify opportunities for process improvement and revenue integrity.

Auditing & Compliance

• Conduct facility audits to evaluate MDS accuracy, supporting documentation, and PDPM performance.
• Provide objective feedback and recommendations that promote compliance, clinical accuracy, and reimbursement integrity.
• Partner with facility leadership to address documentation gaps and strengthen coding practices.
• Ensure recommendations align with CMS regulations, state requirements, and ethical reimbursement practices.
• Support facilities in maintaining audit readiness and regulatory compliance.

Education & Coaching

• Develop strong relationships with MDS Coordinators, DONs, Administrators, and interdisciplinary teams.
• Deliver ongoing education regarding PDPM, MDS coding, documentation requirements, and reimbursement best practices.
• Provide individualized coaching and mentorship to facility teams to increase knowledge, confidence, and consistency.
• Translate complex reimbursement concepts into practical, understandable guidance for clinical staff and leaders.
• Serve as a trusted resource for questions related to PDPM, Medicare reimbursement, and clinical documentation practices.
• Collaborate with regional and facility leadership to support clinical and financial goals.
• Participate in reimbursement reviews, operational meetings, and strategic initiatives.
• Assist with onboarding and training of new MDS and reimbursement personnel.
• Maintain flexibility to travel throughout the region and provide onsite support as needed.
• Manage priorities independently while adapting to changing facility and organizational needs.

Requirements

Qualifications

• Active RN or LPN license.
• Strong knowledge of MDS assessment processes and PDPM reimbursement methodology.
• Experience in skilled nursing, long-term care, or post-acute care settings.
• Excellent interpersonal, verbal, written, and presentation skills.
• Ability to build relationships and effectively influence diverse teams.
• Strong organizational skills and ability to work independently.
• Previous experience as an MDS Coordinator, Clinical Reimbursement Specialist, Clinical Resource Nurse, or Regional MDS/PDPM Consultant.
• Multi-facility oversight, management, or regional support experience.
• Experience conducting audits, reimbursement reviews, or clinical documentation improvement initiatives.
• Demonstrated success training and mentoring clinical teams.
• Strong understanding of Medicare reimbursement and regulatory compliance.

Why Join Us?

• Competitive Salary (depending on experience)
• Medical, dental, and vision benefits
• Paid time off, sick and vacation days
• Life insurance
• 401(k) retirement plan
• Short-term and long-term disability coverage
• Employee Assistance Program (EAP)
• Professional Development Opportunities
• Mission-driven culture dedicated to serving others

Why Join Cascadia Healthcare

At Cascadia Healthcare, you'll have the opportunity to make a meaningful impact across multiple communities by helping facility teams succeed in delivering quality care while navigating the complexities of PDPM reimbursement. You'll join a collaborative organization that values integrity, education, accountability, and continuous improvement.

Join us in building the future of skilled nursing care and be a Force For Good.