Skilled Nursing Facility (SNF) / Patient-Driven Payment Model (PDPM)

Description

A brief coding/auditing assessment may be included as part of the interview process

Salary for this role is $85k - $95k

For more information on benefits and what we offer please visit us at

Responsibilities

Responsibilities:

Deliver structured training and facilitation for SNF/PDPM auditors, including new hire onboarding and ongoing development

Translate audit findings and error trends into targeted training, coaching, and reinforcement activities

Provide one-on-one and group coaching to address performance gaps and improve audit accuracy and consistency

Support trainees in developing strong clinical documentation interpretation and classification logic for SNF claims

Reinforce application of PDPM components, including MDS-driven reimbursement factors

Conduct observation sessions, case reviews, and teach-back activities to validate learner understanding and application

Utilize progress reports and performance data to identify trends, root causes, and opportunities for intervention

Support trainees in achieving performance expectations and progressing efficiently through training to independent production

Partner with Quality, Audit, and SMEs to ensure alignment on audit logic, regulatory guidance, and training priorities

Maintain accurate training documentation, including progress tracking, coaching notes, and performance updates

Own and contribute to the development and enhancement of training materials, case studies, and job aids

Knowledge and Skills:

Strong working knowledge of MDS, PDPM components, and MDS-driven reimbursement

Ability to interpret clinical documentation and apply classification logic accurately in an audit setting

Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners

Ability to translate complex regulatory and clinical concepts into clear, practical, and engaging learning experiences

Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data

Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics

Ability to collaborate cross-functionally with Quality, Audit, and SME partners

Strong organizational and time management skills to manage multiple priorities and deadlines

Proficiency with Excel, PowerPoint, Word, Outlook, and Encoder tools (Optum, TrueCode, 3M, Webstrat) and training / collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)

Qualifications

Qualifications:

RN required; Bachelor’s or Master’s degree preferred

Deep understanding of HIPPS billing codes, MDS 3.0 coding rules, and case management

Minimum 5 years of experience in a Skilled Nursing Facility and/or Long Term Care, auditing, or payment integrity

Strong experience with PDPM (Patient-Driven Payment Model)

Experience with MDS assessments, SNF documentation, and reimbursement structures

Minimum 3 years of experience delivering training, facilitation, or coaching within a coding or audit environment

Knowledge and Skills:

Strong working knowledge of MDS, PDPM components, and MDS-driven reimbursement

Ability to interpret clinical documentation and apply classification logic accurately in an audit setting

Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners

Ability to translate complex regulatory and clinical concepts into clear, practical, and engaging learning experiences

Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data

Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics

Ability to collaborate cross-functionally with Quality, Audit, and SME partners

Strong organizational and time management skills to manage multiple priorities and deadlines

Proficiency with Excel, PowerPoint, Word, Outlook, and Encoder tools (Optum, TrueCode, 3M, Webstrat) and training / collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)

What we offer:

EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions. From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants

You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills—key aspects for personal and professional growth

We provide guidance/coaching to every employee through our mentoring program wherein every junior-level employee is assigned a senior-level professional as an advisor

The sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond