EXL

Temp. Part-time: Skilled Nursing Facility (SNF) / Patient-Driven Payment Model (PDPM)

EXL  •  $36 - $47/hr  •  United States (Remote)  •  24 hours ago
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Job Description

This is a remote position where the SNF/PDPM Quality Analyst is responsible for conducting quality reviews of completed audits, ensuring compliance with CMS regulations, internal policies client requirements, and audit methodologies. The role evaluates the accuracy, consistency, and defensibility of audit determinations, identifies trends and process improvement opportunities, and contributes to overall quality performance and operational excellence.

  • Hourly Range: $36.00 – $47.45
  • Location: 100% Remote (U.S.-based)
  • Up to 10% annual travel (for team meetings and limited client onsite engagements.)

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

Quality Review and Audit Oversight: Demonstrates expertise in the following:

  • Perform quality reviews of completed SNF/PDPM audits to validate coding accuracy, reimbursement determinations, supporting documentation, and audit rationale
  • Ensure audit findings align with CMS guidelines, RAI Manual requirements, PDPM regulations, client requirements, and departmental procedures
  • Document quality review findings clearly and accurately
  • Identify quality trends, recurring audit errors, and opportunities for process improvement
  • Provide constructive written feedback to auditors

Performance Management: Consistently contributes to client saving/internal revenue goals

  • Achieves productivity and quality goals

Team Work: Understands duties, team goals, and consistently achieves performance required

  • Demonstrates awareness of goals by achieving performance requirements (self-accountability)
  • Responds timely to emails and meeting requests (is in attendance as scheduled/requested)
  • Actively participates in discussions and Team Meetings, providing suggestions of improvement or volunteers when needed
  • Adhere to all EXL Health policies and procedures
  • Report any problems in the audit or quality process to Quality Manager for resolution.
  • Identify and communicate facility and provider specific issues that impact audits.

Continuous Improvement / Education

  • Maintain current knowledge of CMS regulations, PDPM reimbursement methodology, MDS 3.0 requirements, and industry best practices
  • Monitor regulatory changes affecting SNF/PDPM auditing activities
  • Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse license in good standing in the state that you reside
  • Minimum of 5 years’ experience with SNF clinical, MDS 3.0 completion, PDPM reimbursement methodology, quality assurance, auditing, and/or related experience
  • Advanced knowledge of MDS 3.0 coding guidelines, skilled nursing facility (SNF) levels of care, and PDPM reimbursement
  • Previous experience/exposure to the billing of HIPPS codes
  • Experience reviewing audit findings, conducting quality revises, or performing compliance monitoring activities

Knowledge & Skills

  • Experience with: Excel, PowerPoint, Outlook, and Word
  • Experience with Encoder tools such as 3M
  • Experience with and expertise with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
  • Must be detail oriented
  • Must have excellent verbal and written communication skills
  • Must be self-directed and able to work with minimum oversight

What We Offer You:

  • A fast-paced, innovative environment with a team of sharp, driven professionals
  • Remote work flexibility and a chance to impact healthcare delivery nationwide
  • Opportunities for growth and mentorship through our structured coaching program
  • A collaborative culture where your ideas and insights are valued
  • Real opportunities for advancement—your future here is what you make it!

At EXL Health, you’ll not only do meaningful work—you’ll grow your career, expand your skills, and be part of a team that values your contribution.

Ready to take your career to the next level? Apply today!

The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.

EXL

About EXL

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments.

At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations.

Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale.

Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact.

We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition.

At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward.

For more information, visit www.exlservice.com.

Industry
Consulting & Advisory
Company Size
10,000+ employees
Headquarters
New York, NY
Year Founded
Unknown
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