MDS Nurse
2 days ago
Position is a Full-Time.
POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for insurance companies. Monitors facility Quality Measures, identifies issues related to Quality Measures and assists facility with a Ohio corrective actions needed to improve overall quality services. Educates Administrator and facility staff on innovative procedures to optimize utilization and reimbursement through the completion of the MDS, care plan and care guide process.
ESSENTIAL POSITION FUNCTIONS:
1. Participates in the Nursing Management weekend on-call rotation and assists in help with medication administration in emergencies.
2. Education - Provides education and assistance to facilities on Medicare/Medicaid related areas including eligibility, certification, coverage, documentation, utilization and reimbursement. Assists facilities with initial certification procedures and follow-up of problem areas. Updates policies and procedures to reflect current changes.
3. Coordination - Interacts with Medicare, Managed Care and Medicaid claims review unit and compliance unit to assist facilities in complying with compaOhio procedures and federal, state and local regulations. Reports regularly to administration on issues and activities. Interacts with the Medicare and managed Care intermediary in professional areas of coverage and documentation. Assists in review and preparation of denied claims or administrative record reviews by outside intermediaries. Responsible to coordinate weekly Insurance/Medicare Meeting for the purpose of evaluating resident progress and ongoing skilled service's needs.
4. Monitoring -Completes and assess compliance with Medicare, Managed Care and Medicaid and third party payers and compaOhio procedures. Establishes systems and programs designed to correct aOhio non-compliance situation. Participates with aOhio outside reimbursement audits to acquire first hand knowledge of areas that might lead to system failures.
5. Administration - Establishes and maintains current statistical data associated with the Medicare, Managed Care and Medicaid programs by region. Cooperates with operations to monitor activities for contractor programs, i.e. therapies, utilization review. Reviews and maintains Medicare, Managed Care and Medicaid reference materials.
6. Financial Management - Monitors and identifies utilization issues. Establishes systems and programs to maximize utilization and reimbursement. Establishes system to identify rehabilitations training needs to provide training and recommendations to enhance therapy utilization. Monitors compliance with third party policies and procedures for authorizations for payment and provision of services.
7. Training - Provides ongoing orientation and training to appropriate facility staff regarding the Medicare, Managed Care and Medicaid and other contracted third party payers. Programs. Provides education regarding changes in aOhio program.
8. Meetings - Coordinates, facilitates and attends meetings.
9. Committees - Attends and participates in committees as assigned.
10. Staff Development - Attends and participates in training and other learning activities at the facility level.
11. Gathers data and gives direction to acquire accurate and timely completion of MDS 3.0 as it relates to Medicare, Managed Care and Medicaid. Monitors, coordinates and enhances the completion of the MDS and the interdisciplinary team members in a professional manner.
12. Makes ones self available for Regional visits to acquire knowledge and discuss Ohio on-going issues at the facility level as it relates to the accurate and timely completion of the MDS.
13. Is the chair person for the care plan meeting and conducts those meetings in a thorough manner capturing the accurate information revealed through the completion of the MDS.
14. Audits adl logs and assessments etc. to ensure that information is accurate and timely in completing the MDS assessment tool.
15. Communicates and observes the Corporate Compliance Program effectively and complies with Code of Conduct when performing work functions.
SUMMARY OF QUALIFICATIONS: Able to perform each of the essential position functions.
1. Prefer two year's experience in Medicare/Medicaid areas in long-term care or clinical training.
2. Must have excellent communication and teaching skills in both individual and group settings.
3. Must be capable of maintaining regular attendance and be available to travel including overnight travel as required.
4. Must be capable of performing all of the essential job functions of this position, with or without reasonable accommodations.
5. Possess working knowledge of MDS 3.0, care plans, care guides and the CMI reimbursement process.
SimplyApply
-
MDS Nurse
1 month ago
Hudson, United States Hudson Elms Nursing Home Full timeHudson Elms Nursing Home - Position is a Full-Time. POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and...
-
MDS Nurse
1 month ago
Hudson, United States Hudson Elms Nursing Home Full timePosition is Part-Time twenty (20) hours per week. POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and...
-
MDS Nurse
1 month ago
Hudson, United States Hudson Elms Nursing Home Full timeJob DescriptionPosition is Part-Time twenty (20) hours per week.POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS...
-
MDS Nurse
1 month ago
Hudson, United States Hudson Elms Nursing Home Full timePosition is Part-Time twenty (20) hours per week. POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for...
-
MDS Nurse
5 days ago
Hudson, United States Hudson Elms Nursing Home Full timePosition is a Full-Time.POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for insurance companies....
-
MDS Nurse
3 weeks ago
Hudson, United States Hudson Elms Nursing Home Full timePosition is a Full-Time.POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for insurance companies....
-
MDS Nurse
1 week ago
Hudson, United States Hudson Elms Nursing Home Full timeJob DescriptionPosition is a Full-Time.POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as...
-
MDS Nurse
1 month ago
Hudson, OH, United States Hudson Elms Nursing Home Full timePosition is Part-Time twenty (20) hours per week. POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for...
-
MDS Nurse
1 month ago
Hudson, OH, United States Hudson Elms Nursing Home Full timePosition is Part-Time twenty (20) hours per week. POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for...
-
MDS Nurse
3 weeks ago
Hudson, OH, United States Hudson Elms Nursing Home Full timePosition is a Full-Time.POSITION SUMMARY: Coordinates and monitors Medicare, Managed Care and Medicaid revenue at the facility. Ensures residents receive optimal skilled services to meet needs for optimal independent function and potential discharge to the community including management of the MDS process and serving as liaison for insurance companies....
-
Nurse Manager
2 weeks ago
Hudson, United States Christian Community Homes and Services Full timeQualifications:Must be a registered nurse currently licensed to practice in the state of Wisconsin. A minimum of three years experience in nursing is required. Experience in long term care management is preferred. Must be able to assess resident conditions and function in multiple priority situations. Must have knowledge of governmental regulations and...
-
Cardiology Nurse Practitioner
6 months ago
Hudson, United States Palm Health Resources Full timeWe are staffing for a highly respected health system in need of Cardiology Nurse Practitioners to join their practice! NEW GRADS ARE ENCOURAGED TO APPLY. Located just two hours from NYC, 30 minutes from Albany, and 3 hours from Boston! This area has been thriving since the pandemic, and this town has earned the nickname "Upstates' Brooklyn" for all the cool...
-
Cardiology Nurse Practitioner
1 month ago
Hudson, United States Palm Careers LLC Full timeWe are staffing for a highly respected health system in need of Cardiology Nurse Practitioners to join their practice! NEW GRADS ARE ENCOURAGED TO APPLY. Located just two hours from NYC, 30 minutes from Albany, and 3 hours from Boston! This area has been thriving since the pandemic, and this town has earned the nickname "Upstates' Brooklyn" for all the...
-
Nurse Practitioner
1 month ago
Hudson Falls, United States Medical Director Services PC Full timeNurse Practitioner (NP) Medical Director Services PC is looking to hire an experienced Nurse Practitioner (NP) to service a skilled nursing facility in Queensbury, NY . New Grads Welcome!! Excellent salary will be offered, commensurate with experience. Provider Duties: Serves in the role of primary care provider to long and short term residents....
-
Full Time Urology Physician
3 weeks ago
Hudson, United States Palm Health Resources Full timeWe are looking for a full time Urologist to join our Urology practice. Our community is thriving and we have a need for a full time Urologist to work in our growing communities in Columbia and Greene County, NY. The applicant would be part of a hospital owned multispecialty group practice but would be joining a small Urology team. You will have the support...
-
Certified Registered Nurse Practitioner
2 months ago
Hudson Falls, United States Quality Talent Group Full timeAbout the job Certified Registered Nurse Practitioner Nurse Practitioner (NP) Medical Director Services PC is looking to hire an experienced Nurse Practitioner (NP) to service a skilled nursing facility in Queensbury, NY. New Grads Welcome!! Excellent salary will be offered, commensurate with experience. Provider Duties: Serves in the role of primary...
-
Registered Nurse Pre Admission
2 months ago
Hudson Falls, United States Quality Talent Group Full timeAbout the job Registered Nurse Pre Admission - Per Diem Glens Falls Center is hiring a RN Admissions Nurse in Glens Falls, NY. Duties Include: Initiate admission assessments on new Residents / hospital returns & initiates initial care plan. Assist with the development & direction of the Nursing Department as directed by the DON. Review PRI's &...
-
Urologist
5 months ago
Hudson, United States Palm Health Resources Full timeDescription : We are looking for a full time Urologist to join our Urology practice. Our community is thriving and we have a need for a full time Urologist to work in our growing communities in Columbia and Greene County, NY. The position is currently for a combined outpatient and inpatient practitioner. The applicant would be part of a hospital owned...
-
Medical Oncology and Hematology Specialist
1 week ago
Hudson, Florida, United States Florida Cancer Specialists Full timeCompany OverviewFlorida Cancer Specialists & Research Institute is a leading national provider of cancer care. With over 250 physicians, 220 nurse practitioners and physician assistants, and nearly 100 locations in our network, we offer unparalleled access to cutting-edge treatments and innovative clinical research.We are recognized by the American Society...
-
Hudson, Ohio, United States Hudson Elms Nursing Home Full timeJob OverviewWe are seeking a highly skilled Skilled Services Coordinator to join our team at Hudson Elms Nursing Home.About the RoleThis is a Full-Time position responsible for coordinating and monitoring Medicare, Managed Care, and Medicaid revenue at the facility. The successful candidate will ensure residents receive optimal skilled services to meet their...
