Quality Analyst – Skilled Nursing Facility, Patient-Driven Payment Model

EXL

Quality Analyst in a remote role conducting quality reviews for SNF/PDPM audits. Ensuring compliance with CMS regulations and identifying improvement opportunities.

Posted 7/9/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $60,100 - $98,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in MDS 3.0 coding guidelines, PDPM reimbursement methodology, and compliance with CMS regulations. Proven ability to conduct quality reviews, identify process improvements, and ensure operational excellence in skilled nursing facilities.

Highest-signal resume keywords

Registered Nurse LicenseMDS 3.0 CompletionPDPM Reimbursement MethodologyQuality Assurance AuditingMedicare Local Coverage Determinations

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

MDS 3.0 Coding GuidelinesQuality ReviewAudit Determinations EvaluationCompliance MonitoringHIPPS Codes Billing

Soft Skills

Detail OrientedExcellent Verbal CommunicationExcellent Written CommunicationSelf-Directed

Tools & Technologies

ExcelPowerPointOutlookWord3M Encoder Tools

Certifications & Qualifications

Licensed Practical NurseLicensed Vocational Nurse

Industry Keywords

Skilled Nursing FacilityCMS RegulationsAudit MethodologiesQuality PerformanceOperational Excellence

About the role

Key responsibilities & impact

Conduct quality reviews of completed audits
Ensure compliance with CMS regulations, internal policies client requirements, and audit methodologies
Evaluate the accuracy, consistency, and defensibility of audit determinations
Identify trends and process improvement opportunities
Contribute to overall quality performance and operational excellence

Requirements

What you’ll need

Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse license in good standing in the state that you reside
5 plus 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
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

Benefits

Comp & perks

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