Reimbursement Services Director jobs in Sioux Falls, SD

Reimbursement Services Director directs and supervises the activities of the claims and provider reimbursement personnel. Handles third-party reimbursement for services rendered to patients. Being a Reimbursement Services Director sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Additionally, Reimbursement Services Director develops policies and procedures compliant with fiscal and regulatory requirements. Oversees the collection of statistical and financial data needed for preparing annual and monthly health insurance reports. May require an advanced degree. Typically reports to top management. The Reimbursement Services Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Reimbursement Services Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Residential Services Director
  • PorchLight Services
  • Madison, SD FULL_TIME
  • POSITION PURPOSE:


    The Residential Services Director (RSD) supports the overall direction, training, management and leadership of home and community-based services (HCBS) programs and staff.  The Residential Services Director is responsible for the supervision of the Assistant Residential Director(s) (ARD) and Team Leaders. The RSD oversees of the implementation of the Person-Centered Planning process, required assessments and services and supports.  Works in conjunction with the Assistant Residential Director and Team Leaders in the implementation and monitoring of participant plans so the highest quality of life is afforded the participants who are supported by Valiant Living. This is an exempt position. 


    RESPONSIBILITIES:


    The Residential Services Director is responsible to complete tasks related to the oversite of multiple sites in coordination with the Assistant Residential Services Directors and Team Leaders of each site, to ensure the overall functioning of the sites in terms of programmatic and individual services. In lieu of no acting Team Leader or Assistant Residential Director (ARD), the Residential Services Director assumes the responsibilities for overseeing the overall function of the sites. The RSD and ARD work together to support each other and assist with problem solving for all residential sites. The Residential Services Director supervises the Assistant Residential Director.


    SUPERVISOR:  Executive Director


    ESSENTIAL DUTIES:


    • Performs, oversees, and trains direct care duties for participants living in the home.

    • Assists in providing training and direction to Assistant Residential Director, Team Leaders, Direct Support Professionals, and Direct Support Assistants in all areas of participant services in residential settings.

    • Develops, trains, and monitors participant programs as outlined in the ISP. 

    • Provides oversight on medication management.

    • Completes documentation according to regulatory requirements. 

    • Able to use Microsoft Office programs, Therap documentation software, email, and phone systems. 

    • Identifies and responds to individual needs in emotional and social areas; however, intervention in these areas does not fall within the meaning of psychotherapy.

    • Performs tasks that fall within Category II of infection control that may include exposure to blood, body fluids or tissue. 



     

     

    Management:  


    • Responsible to aid in the hiring process, train, supervise, evaluate, and manage the Assistant Residential Director, Team Leaders, and Direct Support Professionals. 

    • Assist Team Leaders to create monthly and weekly schedules for residential locations and follow up as necessary.  This is to assure 24-hour staffing and maintain staffing levels according to budgetary, quality and safety guidelines per policies.  

    • Verifies payroll t-sheets for residential ARD, Team Leaders, and DSPs in accordance with related policy and by comparing schedules with payroll t-sheets generated by the Business Office. 

    • Assures the appearance of the residential locations and grounds meet standards for sanitation and infection control through routine evaluation process.  This includes but is not limited to Health and Safety Data Collection for all residential locations.  

    • Assists to evaluate the performance of the ARD, Team Leaders, and Direct Support Professionals.

    • Evaluates overall functioning of participant services and agency systems. This includes but is not limited to assuring that all residential locations have available all equipment and materials necessary for service provision through routine inventory and ordering processes, and that all equipment is in good repair. 

    • Participates in the development and implementation of organization goals and objectives.  

    • Participates in The Council on Quality and Leadership (CQL) and agency biennial reviews, as necessary.

    • Assists to plan, develop, and provide in-service education and orientation to staff.

    • Assists with coordinating the pre-admission, admission, and discharge of all participants, collaborating with the Services and Supports Director, Team Leaders, Assistant Residential Director, and the Admissions Committee.


    Individual Services:

     

    • Advocates for the needs of the participant receiving services and supports at Valiant Living, Inc.

    • May assist in the development, implementation, and monitoring of Individualized Support Plans in conjunction with the DSS.  

    • May coordinate and/or facilitate participant meetings with the ARD and Team Leaders, if needed. 

    • Participates in responding to Critical Incident Reports and GER’s in accordance with established regulations and policy.

    • Assists in providing training and direction to the Assistant Residential Director, Team Leaders, DSPs, and DSAs in all areas of participant services.

    • Acts as a Sengistix contact in collaboration with the Assistant Residential Director.

    • Performs direct care duties as necessary, including assisting participants with activities of daily livings, transfers, community integration, and passing medications. Performs tasks that fall within Category II of infection control; which may include exposure to blood, body fluids or tissue. 

    • Responds to participants’ needs in emotional and social areas.  However, intervention in these areas does not fall within the meaning of psychotherapy. 

    • Ensures checking accounts are accurate and up to date each day that you work.

    • Manages participant finances per established procedures from Benefits Specialist.

    • Teaches financial responsibilities as they pertain to each participant, including to help participants pay their monthly bills as received.





    Health and Safety:  


    • Adheres to all safety policies and procedures, fosters awareness and actions that promote a safe living and working environment.  

    • Maintains an injury free workplace by identifying and reporting unsafe conditions.

    • Initiates problem solving to develop correction plan and injury prevention.

    • Assists with fire drills, tornado drills, and other safety areas specific to each participant.

    • Follows dietary recommendations specific to each participant you assist, when preparing meals, assists with feeding and following healthy lifestyle recommendations specific to the participant’s diagnosis (i.e. high cholesterol, diabetic, high blood pressure etc.)

    • Observes and monitors for health and safety concerns at all times.  

    • Assists each participant with identifying potential risks, at home, work and in the community.  (e.g. pedestrian safety, personal care, safe administration of medications, sexuality)  

    • Assists the participants to develop a plan and provide teaching to ensure the participants’ safety.


    Regulation Compliance:


    • Understands, implements, and complies with all policies, procedures, and philosophy of Valiant Living, Inc.; as well as all rules and regulations of licensing agencies and accreditation organizations; to include but not limited to ARSD 46:11 and CQL. 

    • Assures regulation adherence by staff by developing systems to ensure continual regulation compliance and quality services.  Homes are regulation and inspection ready as a performance expectation.


    Fiscal Integrity: 


    • Assists to monitor participant billing rates on a routine basis and request revisions as needed.

    • Monitor fiscal responsibility for purchases made on behalf of the Valiant Living residential locations.

    • Understands residential staffing budget and requests.


    Development of Position:  


    • Assists to develop and provide in-service training to team members through orientation, leadership classes, Supervisor and Leadership meetings, and area house meetings.

    • Attends all mandatory in-services and meets annual training requirements.  

    • Participates as a member of the Health and Safety Committee. 

    • Participates in other committees as requested or as necessary; proposes new ideas for growth.  

    • Takes on extra projects as appropriate and as delegated by the Executive Director.


    Customer/Human Relations:


    • Communicates effectively with participants, Valiant Living staff, families, interdisciplinary team members, and community members, both verbally and in writing.  

    • Responds to communication (phone, electronic, etc.) in a timely manner.

    • Responds to participant complaints in a timely and professional manner, while assessing for necessary system changes, training and monitoring of programs.

    • Displays cooperative, supportive, and positive conduct and presents self as an effective role model in representing Valiant Living, Inc.



    Requirements

    QUALIFICATIONS:


    • Bachelor’s Degree in Human Services, Psychology, or Social Work. Master’s degree in Psychology, Social Work, Gerontology, or Health Administration preferred.

    • Demonstrates proficiency in DSP and Team Leader Competencies.  

    • Three or more years supervisory/management experience in long-term and/or residential settings preferred.

    • Ability to complete all ARSD training requirements within required time. 

    • Ability to maintain a flexible schedule, which may include working weekends and holidays.  

    • Ability to be responsible for 24-hour on-call coverage and respond to issues as necessary.

    • Excellent problem solving, decision-making, and organizational skills.

    • Ability to read, write, and speak the English language adequately to respond to participant needs.

    • Communicates effectively both verbally and in writing; listens accurately and responsively.  

    • Responds to communication in timely manner and reviews e-mail and Therap daily.

    • Ability to see and hear in order to perform assessments.  

    • Holds a valid driver’s license and maintains a safe driving record to travel between multiple sites.

    • Ability to respond to emergencies in accordance with procedures and guidelines.

  • 2 Days Ago

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Director of Clinical Services
  • SOUTHERN PLAINS BEHAVIORAL HEALTH SERVICES
  • Sioux Falls, SD FULL_TIME
  • ***This position is located in Winner, SD. Relocation or Commute Required** About Us Southern Plains Behavioral Health Services (SPBHS) is a leading behavioral health organization based in South Centr...
  • Just Posted

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Social Services Director
  • Avantara Huron
  • Huron, SD FULL_TIME
  • Are you looking for a rewarding career in Skilled Nursing? We are currently searching for a Social Services Director to join our friendly, caring and supportive team! Avantara Huron is rapidly growing...
  • 11 Days Ago

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Dining Services Director
  • Edgewood Healthcare
  • Mitchell, SD FULL_TIME
  • Full-TimeDay Shift Benefits: Access your paycheck early Training provided Paid time off begins accruing day 1 Health, vision, dental, & HSA plans 401K plan with employer contribution As a Dining Servi...
  • 13 Days Ago

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Surgical Services Director
  • Prairie Lakes Healthcare System
  • Watertown, SD FULL_TIME
  • Job Code: Surgical Services Director - Full Time Department: Operative Services Shift: Day Shift Job Type: Full Time (1.0) Job Description: POSITION SUMMARY - Plans, directs, supervises, and evaluates...
  • 4 Days Ago

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Director of Facilities Services
  • Huron Regional Medical Center
  • Huron, SD FULL_TIME
  • JOIN OUR TEAM! Huron Regional Medical Center is a 25-bed critical access hospital located in the heart of South Daktoa. HRMC provides state-of-the-art health care with a caring, compassionate touch to...
  • 5 Days Ago

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0 Reimbursement Services Director jobs found in Sioux Falls, SD area

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IT Director - Mainframe and Operations
  • Paragon IT Professionals
  • Sioux Falls, SD
  • Job Summary: The Mainframe and Operations Director is responsible for overseeing the efficient operation and maintenance...
  • 4/19/2024 12:00:00 AM

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Conservation Director
  • Ida County Conservation Board
  • Sioux Falls, SD
  • Job Description Job Description Organization: The Executive Director is the representative of the Ida County Conservatio...
  • 4/19/2024 12:00:00 AM

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Director of IT - Mainframe
  • Aureon Consulting
  • Sioux Falls, SD
  • We have an exciting opportunity for a dynamic leader to oversee Mainframe Systems and Operations! Individual must be wil...
  • 4/19/2024 12:00:00 AM

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Director of Procurement
  • POET
  • Sioux Falls, SD
  • ABOUT POET At POET, it is our mission to be good stewards of the Earth by converting renewable resources to energy and o...
  • 4/18/2024 12:00:00 AM

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Director of Fundraising
  • Sheryl Johnson for Congress
  • Sioux Falls, SD
  • Director of Fundraising (Finance Director) Sheryl Johnson, the Democratic Candidate for South Dakota’s lone seat in the ...
  • 4/18/2024 12:00:00 AM

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Director of Fundraising
  • Sheryl Johnson For Congress
  • Sioux Falls, SD
  • Director of Fundraising (Finance Director) Sheryl Johnson, the Democratic Candidate for South Dakotas lone seat in the H...
  • 4/18/2024 12:00:00 AM

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Director of Procurement
  • Poet
  • Sioux Falls, SD
  • ABOUT POET At POET, it is our mission to be good stewards of the Earth by converting renewable resources to energy and o...
  • 4/16/2024 12:00:00 AM

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Director of Quality and Risk
  • Encompass Health
  • Sioux Falls, SD
  • The Quality/Risk Director is responsible for an environment and culture that enables the hospital to fulfill its mission...
  • 4/15/2024 12:00:00 AM

Sioux Falls (/ˌsuː ˈfɔːlz/) (Lakota: Íŋyaŋ Okábleča Otȟúŋwahe; "Stone Shatter City") is the most populous city in the U.S. state of South Dakota and the 143rd-most populous city in the United States. It is the county seat of Minnehaha County and also extends into Lincoln County to the south, proximate with the Minnesota state line. It is the 47th-fastest-growing city in the United States and the fastest-growing metro area in South Dakota, with a population increase of 22% between 2000 and 2010. As of 2019, Sioux Falls had an estimated population of 187,200. The metropolitan population of 259,0...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Services Director jobs
$136,767 to $194,758
Sioux Falls, South Dakota area prices
were up 0.8% from a year ago

Reimbursement Services Director in Albuquerque, NM
The Manager will be responsible for either audit or reimbursement functions, and can be responsible for one of four primary roles – desk review/audit, reopenings/appeals, interim rate review/reimbursement or acceptance/finalization for all provider types as both a preparer and reviewer of work product.
December 27, 2019
Reimbursement Services Director in Little Rock, AR
The Manager assigns annual workload budget, distributes assignments to the team, ensures timely and accurate completion and review of all work, and makes final reimbursement determinations for all work assigned to the team.
February 24, 2020
Reimbursement Services Director in Las Vegas, NV
The Director of Reimbursement will consistently improve processes and develop their teams to exceed established KPIs and raise collection revenue, while lowering the overall cost to deliver these services.
January 05, 2020