Assistant Vice President (AVP) of Clinical Quality

Why You’ll Love Us:

• Purpose-Driven Mission: Make a direct impact on resident outcomes, staff development, and healthcare transformation.
• Executive Leadership Collaboration: Work closely with our VP of Health Services to advance strategic initiatives.
• Influence Across Sites: Guide quality and compliance across skilled nursing, assisted living, and memory care communities.
• Professional Growth: Expand your impact while advancing your expertise in value-based care and regulatory strategy.
• Culture of Excellence: Join a supportive, collaborative team that values integrity, accountability, and innovation.

Why We’ll Love You:

• You’re a licensed Registered Nurse (RN) in Ohio with at least 5 years of leadership experience in healthcare operations, MDS, risk management, and quality improvement.
• You have a deep understanding of Medicare/Medicaid reimbursement models, including PDPM and Ohio-specific value-based programs.
• You bring a proactive approach to regulatory compliance, including CMS, Joint Commission, and ODH standards.
• You’re a data-driven leader with strong analytical skills and a passion for continuous improvement.
• You’re experienced in managing MDS teams, clinical budgets, and interdisciplinary care planning.
• You mentor, educate, and inspire clinical teams to deliver best-in-class care.
• You’re tech-savvy and comfortable using EHRs and healthcare software to drive outcomes.

Ready to Lead with Purpose?

• Oversee clinical care delivery across all levels of care, including skilled nursing, memory care, and assisted living.
• Collaborate with the Directors of Nursing and clinical department heads to ensure optimal resident care outcomes
• Lead interdisciplinary care planning and coordination efforts
• Monitor clinical metrics, quality indicators, and resident satisfaction scores
• Ensure appropriate staffing levels and clinical resource allocation

• Develop, implement, and monitor comprehensive quality assurance programs
• Lead preparation for state surveys, Joint Commission visits, and other regulatory inspections
• Oversee infection control protocols and safety programs
• Manage quality improvement initiatives and performance improvement projects
• Ensure compliance with CMS regulations, state licensing requirements, and accreditation standards
• Coordinate with AVP of Health Services on risk management, incident analysis and corrective action plans.
• Stay abreast of all new regulations and ensure buildings are educated and trained.

• Collaborate with hospital systems, physicians, and community partners to ensure seamless care transitions
• Ensure appropriate level of care placements and clinical assessments
• Oversee MDS staff and to ensure we are capturing and maximizing reimbursement, meeting bi weekly with this team to review metrics.
• Review monthly budget numbers with AVP Health Services, Executive Directors, and Directors of Nursing to discuss any variances and develop plan of corrections if needed.
• Attend Quarterly Variance meetings with AVP Health Services and VP of Health Services.

• Oversee compliance with Ohio Department of Medicaid (ODM) nursing facility payment methodologies and rate-setting processes
• Navigate Ohio's PASSPORT waiver program and Assisted Living waiver compliance
• Ensure compliance with Ohio's Quality Incentive Program and value-based payment initiatives
• Oversee standardized Level of Care assessment protocols and timeliness
• Maintain expertise in Ohio Department of Health nursing home regulations and reimbursement implications
• Manage Ohio-specific quality reporting requirements that impact reimbursement rates
• Oversee Minimum Data Set (MDS) 3.0 assessment processes to ensure accurate coding and optimal reimbursement under PDPM (Patient Driven Payment Model)
• Develop and maintain MDS coding protocols to maximize case-mix index while ensuring clinical accuracy and regulatory compliance
• Implement quality assurance programs for MDS assessments
• Manage MDS submission timelines to CMS QIES system and ensure compliance with assessment scheduling requirements (5-day, 14-day, 30-day, 60-day, and discharge assessments)
• Analyze PDPM payment components (PT, OT, SLP, Nursing, Non-Therapy Ancillary) to optimize resident classification and reimbursement
• Ensure accurate ICD-10 diagnosis coding to support appropriate PDPM case-mix assignments
• Develop processes to capture and document all relevant clinical conditions and functional deficits that impact payment classification
• Monitor PDPM payment adjustments and appeals processes for coding disputes
• Oversee MDS-based Quality Measures reporting to maintain and improve CMS Five-Star Quality Rating System scores
• Implement strategies to optimize performance on MDS-derived quality measures that impact reimbursement and market competitiveness
• Manage MDS data accuracy to support Ohio Department of Health quality reporting requirements
• Coordinate with clinical teams to ensure MDS assessments accurately reflect resident acuity and care needs

• Partner with Human Resources on clinical staff recruitment and retention strategies
• Oversee clinical education programs and competency assessments
• Mentor department managers and clinical supervisors
• Support professional development initiatives for nursing and clinical staff
• Lead clinical policy development and procedure updates

• Participate in strategic planning initiatives related to clinical services
• Analyze clinical and financial data to identify improvement opportunities
• Support census development and occupancy optimization efforts
• Collaborate on budget planning for clinical departments
• Lead or participate in facility expansion or renovation projects affecting clinical operations

Education: Graduated from an accredited school of nursing

Licenses or other required certifications: Must be a licensed RN in the state of Ohio and have the ability to become CPR certified.

Experience: At least five years of experience within the health care field to include experience with MDS, Risk-Management, Corporate Compliance, and QAPI.

Specialized knowledge, skills, or abilities:

• Registered Nurse with experience in health, long-term care management/billing required. Must possess familiarity with State and Federal regulations, Medicare/Medicaid, and other accreditation requirements
• Must have demonstrated knowledge of corporate compliance and ethics
• Must possess the ability to make independent decisions when circumstances warrant such action
• Must possess the ability to seek out new methods and principles and be willing to incorporate them into existing practices
• Excellent analytical and abstract reasoning skills, plus excellent organizational skills.
• Must be computer proficient
• Must be knowledgeable of medical terminology, basic grammar and spelling skills
• Must possess the ability to present professionally and deal tactfully with personnel, residents, family members, visitors, government agencies, employees and the general public.
• Must possess the ability to seek out new methods and principles and be willing to incorporate them into existing department practices
• Professional in the use of verbal and nonverbal communication and behavior. The use of oral, written and electronic communication and/or devices is appropriate. Communicates pertinent information to the appropriate people in a timely and appropriate manner.
• Consistently demonstrates courteous and polite behavior. Is respectful, helpful and prompt in responding to needs and requests of customers. Listens for understanding to determine if clarification is needed. Demonstrates understanding of the company purpose and mission.
• Demonstrates an appropriate level of ability to achieve desired outcomes by setting goals and priorities for the team that deliver results. Resolves conflict effectively. Acts in a fair and just manner. Motivates and guides team members. Invests in the growth and development of team members. Models the behavior he/she expects of others. Attracts and retains a quality workforce.
• Consistently demonstrates the ability to perform job duties as outlined in the job description and other duties as assigned. Performs work in accordance with regulations, nursing policies and within budgetary constraints. The delivery of service is timely and appropriate. The work produced is thorough, accurate and complete, the quantity of work standards is met and is process-improvement oriented.
• Understands and adheres to the policies outlined in our employee handbook.
• Completes all mandatory in-service training within the designated time frames.
• Proactively maintains licensure and/or certifications necessary to perform the job.
• Regularly attends and participates in staff meetings.
• Adheres to safety and sanitation standards.
• Demonstrates the ability to be accountable, dependable and trustworthy.