Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kristen Walden

Panama City,FL

Summary

Dynamic Registered Nurse and Resident Assessment Certified MDS Consultant with over twenty-seven years of extensive experience in long-term care, excelling in roles such as MDS Coordinator, Director of Nursing, multi-site/state Corporate Nurse, and Clinical Reimbursement Consultant. Expertise includes MDS validation audits, quality assurance, PDPM and case mix reimbursement compliance, and restorative nursing programming. Proven track record in policy and procedure development, regulatory compliance, and ensuring SNF/NF survey readiness while consistently achieving Nursing Home Five Star quality measures goals. Committed to enhancing patient care through strategic leadership and a deep understanding of industry standards.

Overview

28
28
years of professional experience
1
1
Certification

Work History

Clinical Reimbursement Specialist

MDS Solutions
02.2025 - Current
  • Ensure accurate reimbursement and compliance with federal quality reporting requirements.
  • Provide expert guidance with PDPM and case mix reimbursement systems and processes.
  • Deliver high-quality, client-focused services, including reimbursement optimization, education, system analysis and creative problem-solving recommendations.

Clinical Reimbursement Consultant

R2/Reimbursement Reimagined (Zimmet Healthcare Services Group, LLC)
02.2021 - 01.2025
  • Provided reimbursement review for PDPM and case mix for clients with excellent optimization results.
  • Ensured appropriate reimbursement, regulatory compliance, and risk mitigation.
  • Implemented and executed tailored workflow processes with improved reimbursement results and monitored key reimbursement metrics trends.
  • Provided educational resources and webinars for new updates and client-focused needs.

Clinical Reimbursement Consultant

Proactive LTC Consultants
10.2019 - 02.2021
  • Performed documentation and coding compliance audits for Medicare, Medicaid, and private insurances with process improvement recommendations with positive results.
  • Assisted with achieving and maintaining higher CMS Five-Star ratings.
  • Developed and presented clinical and reimbursement content educational webinars.
  • Assisted with audit defense/Alternate dispute resolution response management with favorable outcomes.
  • Developed content for policy and procedures, documentation forms, internet blogs, and white papers.

Clinical Reimbursement Consultant

Signature Healthcare LLC
01.2018 - 10.2019
  • Provided reimbursement consultation for regional health centers in Kentucky, Tennessee, and Indiana increasing CMI and Medicare rates.
  • Identified coding opportunities to reflect accurate reimbursement with increased compliance.
  • Prepared and provided clinical reimbursement quality analysis.
  • Served as super user and trainer for effective EHR software use.

Nursing Consultant

Signature Healthcare LLC
01.2017 - 01.2018
  • Promoted to corporate Nursing Consultant.
  • Provided nursing consultation for regional health centers in Kentucky and Tennessee providing enhanced clinical outcomes and survey results.

Director of Nursing

Signature Healthcare of Clarksville
01.2016 - 01.2017
  • Provided oversight and guidance to nursing staff.
  • Ensured clinical systems and standards of care achievement with clinical, regulatory, and reimbursement compliance and infection prevention and control with excellent outcomes.
  • Developed and executed training programs for nursing personnel, improving team competency and retention.

Nursing and Clinical Reimbursement Consultant

Christian Care Communities
01.2014 - 01.2016
  • Promoted to corporate consultant.
  • Provided guidance regarding Medicare, Medicaid, and private insurance reimbursement.
  • Partnered with clinical and financial team members to develop and enhance clinical reimbursement tools and systems with positive workflow and improved financial successes.
  • Served as super user and trainer for EHR software.

MDS Coordinator

Christian Health Center
01.2008 - 01.2014
  • Reviewed medical records for accurate and complete documentation.
  • Coded MDS assessments with capture of appropriate clinical information and follow-through for clarification or recommendations for improvement.
  • Provided interventions to ensure appropriate enhanced reimbursement and improved quality measures.

Admissions Coordinator/Case Manager

Christian Health Center
01.2007 - 01.2008
  • Reviewed and screened referrals for admission criteria and managed insurance-related tasks.
  • Coordinated and facilitated patient care with coordination of interdisciplinary team, patients and families, to ensure continuity of care.
  • Educated patients and families regarding available community resources.
  • Managed discharge plans including referrals, services, and equipment.

Nursing Instructor

Kentucky Community and Technical College Systems
01.2006 - 01.2007
  • Demonstrated and instructed licensed practical nurses regarding patient care and nursing academics in classroom, lab, and clinical settings navigating complex clinical scenarios and challenging students to foster strong decision-making skills.

Director of Nursing

Christian Health Center
01.2005 - 01.2006
  • Led nursing staff in achieving and maintaining regulatory compliance with successful survey outcomes.
  • Established and maintained a strategic quality assurance program improving resident wellness and reducing hospital readmissions.

MDS Coordinator

Christian Health Center
01.2003 - 01.2005
  • Facilitated accurate assessments leading to more effective treatments, reducing complications and improving 5-Star ratings and reimbursement.
  • Assessed each resident's physical, mental and social needs to create tailored care plans enhancing quality of life.

Nursing Supervisor

Christian Health Center
01.2002 - 01.2003
  • Served as day shift supervisor with enhanced care delivery outcomes and team cohesion.

Director of Nursing

Hearthstone Place
01.2000 - 01.2002
  • Led nursing department to assure improved quality of care and regulatory compliance as well as resident and staff satisfaction.

Staff RN

Jennie Stuart Medical Center
01.1999 - 01.2000
  • Provided and planned nursing care and support for medical surgical patients enabling care coordination for prevention of complications and successful discharge.

Staff RN

St. Vincent's Medical Center
01.1998 - 01.1999
  • Managed complex, post operative and chronic conditions for PCU patients ensuring smooth transition from ICU to lower-acuity care reducing complications and improved long-term outcomes.

Education

Master of Science - Nursing

Chamberlain College of Nursing

Bachelor of Science - Nursing

Indiana Wesleyan University
01.2006

Associate of Science - Nursing

Madisonville Community College
01.1998

Skills

  • Skilled Nursing Facility
  • Reimbursement Optimization
  • Medicare PDPM
  • Medicaid CMI
  • ICD-10 Coding
  • Quality Measures
  • Compliance
  • Problem-solving abilities
  • Analytical thinking
  • Customer service
  • Interpersonal skills
  • Reliability

Certification

  • Nurse Licensure Compact/ Multistate Registered Nurse: Florida
  • Resident Assessment Coordinator–Certified (RAC-CT)
  • Association of Clinical Documentation Integrity Specialists (ACDIS) Clinical Documentation Improvement (CDI) Apprenticeship

Timeline

Clinical Reimbursement Specialist

MDS Solutions
02.2025 - Current

Clinical Reimbursement Consultant

R2/Reimbursement Reimagined (Zimmet Healthcare Services Group, LLC)
02.2021 - 01.2025

Clinical Reimbursement Consultant

Proactive LTC Consultants
10.2019 - 02.2021

Clinical Reimbursement Consultant

Signature Healthcare LLC
01.2018 - 10.2019

Nursing Consultant

Signature Healthcare LLC
01.2017 - 01.2018

Director of Nursing

Signature Healthcare of Clarksville
01.2016 - 01.2017

Nursing and Clinical Reimbursement Consultant

Christian Care Communities
01.2014 - 01.2016

MDS Coordinator

Christian Health Center
01.2008 - 01.2014

Admissions Coordinator/Case Manager

Christian Health Center
01.2007 - 01.2008

Nursing Instructor

Kentucky Community and Technical College Systems
01.2006 - 01.2007

Director of Nursing

Christian Health Center
01.2005 - 01.2006

MDS Coordinator

Christian Health Center
01.2003 - 01.2005

Nursing Supervisor

Christian Health Center
01.2002 - 01.2003

Director of Nursing

Hearthstone Place
01.2000 - 01.2002

Staff RN

Jennie Stuart Medical Center
01.1999 - 01.2000

Staff RN

St. Vincent's Medical Center
01.1998 - 01.1999

Associate of Science - Nursing

Madisonville Community College

Master of Science - Nursing

Chamberlain College of Nursing

Bachelor of Science - Nursing

Indiana Wesleyan University

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Kristen Walden