MDS Nurse Coordinator

5 months ago

Warren, United States Medina Center for Rehabilitation Full time
Job DescriptionJOB DESCRIPTION

MDS COORDINATOR

DEPARTMENT:                    Clinical Reimbursement

POSITION:                            CLINICAL REIMBURSEMENT SPECIALIST

SUPERVISOR:                      Administrator

POSITION SUMMARY:        Coordinates Medicare, Managed Care and Medicaid activities at the facility.  Educates Administrator and facility staff on innovative procedures to maximize utilization and reimbursement through the completion of the MDS, care plan and care guide process.

ESSENTIAL POSITION FUNCTIONS:

  • 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. 

  • Coordination – Interacts with Medicare, Managed Care and Medicaid claims review unit and compliance unit to assist facilities in complying with company 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.

  • Monitoring –Completes and assess compliance with Medicare, Managed Care and   Medicaid and third party payers and company procedures.  Establishes systems and programs designed to correct any non-compliance situation. Participates with any outside reimbursement audits to acquire first hand knowledge of areas that might lead to system failures.

  • 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.

  • 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.

  • 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 any program.

  • Meetings – Coordinates, facilitates and attends meetings.

  • Committees – Attends and participates in committees as assigned.

  • Staff Development – Attends and participates in training and other learning activities at the facility level.

  • 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.

  • Makes ones self available for Regional visits to acquire knowledge and discuss any on-going issues at the facility level as it relates to the accurate and timely completion of the MDS.

  • 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.

  • Audits adl logs and assessments etc. to ensure that information is accurate and timely in completing the MDS assessment tool.

  • All other duties as assigned.

  • 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.

  • A Registered Nurse in the State of New York with a Bachelor’s Degree in nursing is preferred, but not limited to this requirement.

  • Prefer two year’s experience in Medicare/Medicaid areas in long-term care or clinical training.

  • Must have excellent communication and teaching skills in both individual and group settings.

  • Must be capable of maintaining regular attendance and be available to travel including overnight travel as required.

  • Must be capable of performing all of the essential job functions of this position, with or without reasonable accommodations.

  • Possess working knowledge of MDS 3.0, care plans, care guides and the CMI reimbursement process.

    This organization reserves the right to revise essential position functions and responsibilities as the need arises.

  • MDS Coordinator

    2 months ago

    Warren, United States Warren Nursing and Rehab Full time

    We are currently searching for an experienced MDS Coordinator to join our Warren Nursing & Rehab team. The ideal candidate would hold an active LPN or RN License in Ohio. This individual will complete and ensure accuracy of the MDS process for all residents, including reviewing CMI for risks and changes, monitoring MC/PPS assessment schedules and...

  • MDS Coordinator

    4 weeks ago

    Phillipsburg, NJ, Warren County, NJ; New Jersey, United States Genesis HealthCare Full time

      Benefits *Nursing Student Loan Debt Repayment and Tuition Assistance *Variable compensation plans *Tuition, Travel, and Wireless Service Discounts *Employee Assistance Program to support mental health *Employee Foundation to assist financially with unforeseen hardships *Diverse, Equitable, and Inclusive (DEI) workplace with DEI committee. DEI is a part of...

  • Director MDS

    3 months ago

    Warren, United States Washington Square Nursing & Rehab Full time

    Come join our dedicated and award winning team in caring for America's Bravest ! This is an exciting time to be at Washington Square's newly remodeled facility, giving back to our Veterans ! We are excited to announce: Voted Best of The Best Nursing Home for the past TEN Years by the Tribune Chronicle Trumbull County's ONLY Veteran's Provider Recently...

  • Director of MDS

    3 months ago

    Warren, United States Washington Square Nursing & Rehab Full time

    Come join our dedicated and award winning team in caring for America's Bravest ! This is an exciting time to be at Washington Square's newly remodeled facility, giving back to our Veterans ! We are excited to announce: Voted Best of The Best Nursing Home for the past TEN Years by the Tribune Chronicle Trumbull County's ONLY Veteran's Provider Recently...

  • Director | MDS

    3 months ago

    Warren, United States Washington Square Nursing & Rehab Full time

    Job DescriptionCome join our dedicated and award winning team in caring for America's Bravest !This is an exciting time to be at Washington Square's newly remodeled facility, giving back to our Veterans !We are excited to announce:Voted Best of The Best Nursing Home for the past TEN Years by the Tribune ChronicleTrumbull County's ONLY...

  • Patient Care Coordinator

    22 hours ago

    Warren, Michigan, United States Steward Health Care Full time

    Patient Care CoordinatorAt Steward Health Care, we strive to deliver exceptional, personalized patient care with dignity, compassion, and respect. As a Patient Care Coordinator, you will be responsible for supporting the nursing philosophy and providing high-quality, comprehensive patient care. You will work closely with the interdisciplinary team to ensure...

  • Intake Referral Coordinator

    1 month ago

    Warren, United States Behavioral Center of Michigan Full time

    The Behavioral Center of Michigan, an accredited psychiatric hospital providing high levels of psychiatric care to adult patients and committed to person focused care, is looking for an Intake Referral Coordinator who will be responsible for obtaining initial clinical information which is communicated to the Charge Nurse or physician. The coordinator...

  • Logistics Coordinator

    4 weeks ago

    Warren, Michigan, United States Novelis Full time

    Job Summary:Novelis is seeking a Logistics Coordinator to join our team in Warren, Ohio. In this role, you will be responsible for accurate and timely scheduling, communications, and documentation for deliveries of products to customers by organizing truckloads and schedules. This position is accountable for processing finished goods and scrap shipments,...

  • Enhanced Service Coordinator

    4 months ago

    Warren, United States Presbyterian Villages of Michigan Full time

    Overview: Responsible for assessing and identifying resident needs and outside resources to meet those needs. Areas of assistance may include physical, mental, psychological and/or social as it relates to aging and supporting residents as they live independently. Enhanced Service Coordinators proactively help residents self-manage chronic diseases, link them...

  • RN Coordinator

    6 days ago

    Warren, United States Henry Ford Hospital Full time

    Coordinates a centralized bed management system to facilitate efficient admissions and transfers, optimize occupancy and avoid delays in service. Responsibilities: Communicates with clinical staff to determine status of pending discharges, transfers and bed availability and plans bed assignments accordingly.| Reviews all admissions and transfers for...

  • Logistics Coordinator

    4 months ago

    Warren, United States Novelis Full time

    Overview The Supply Chain & Logistics team, located in Warren, Ohio, is seeking a Logistics Coordinator! This position is accountable for accurate and timely scheduling, communications, and documentation for deliveries of products to customers by organizing truckloads and schedules. This position is responsible for processing finished goods and scrap...

  • Senior Living Community Service Coordinator

    1 month ago

    Warren, United States Presbyterian Villages of Michigan Full time

    Job Summary:The Service Coordinator assumes responsibility for coordinating programs and services to help residents maintain a good quality of life and age in place. This role involves assessing and identifying resident and family needs and outside resources to meet those needs.Key Responsibilities:Network with community organizations to seek affordable and...

  • Patient Care Coordinator

    6 days ago

    Warren, Michigan, United States Henry Ford Hospital Full time

    Job SummaryWe are seeking a skilled Registered Nurse to join our team at Henry Ford Hospital. As a key member of our healthcare team, you will be responsible for delivering high-quality patient care and ensuring the best possible outcomes for our patients.About the RoleThis is a full-time RN position with an attractive salary and benefits package. The...

  • LPN Patient Care Team Coordinator

    4 hours ago

    Warren, Ohio, United States Patient Care Full time

    Job SummaryWe are seeking an experienced LPN to join our team as a Patient Care Team Coordinator. This is a fantastic opportunity to work in a dynamic and supportive environment, where you will be responsible for coordinating care teams to ensure the highest quality patient outcomes.Key ResponsibilitiesAssist the Patient Care Manager in coordinating a team...

  • RN Coordinator

    5 days ago

    Warren, United States Henry Ford Health System Full time

    Coordinates a centralized bed management system to facilitate efficient admissions and transfers, optimize occupancy and avoid delays in service. Responsibilities: Communicates with clinical staff to determine status of pending discharges, transfers and bed availability and plans bed assignments accordingly.| Reviews all admissions and transfers for...

  • RN Coordinator

    8 hours ago

    Warren, United States Henry Ford Health System Full time

    Coordinates a centralized bed management system to facilitate efficient admissions and transfers, optimize occupancy and avoid delays in service. Responsibilities: Communicates with clinical staff to determine status of pending discharges, transfers and bed availability and plans bed assignments accordingly.| Reviews all admissions and transfers for...

  • LPN Patient Care Team Coordinator

    2 hours ago

    Warren, Ohio, United States Patient Care Full time

    Job Summary: We are seeking a highly skilled LPN to serve as a Patient Care Team Coordinator, assisting our team in providing exceptional patient care and ensuring the continuity of high-quality services.About Us: As a leading healthcare provider, we pride ourselves on delivering personalized care that meets the unique needs of each patient. Our commitment...

  • Physician - Full-time - Maine State Prison

    3 months ago

    Warren, United States Wellpath Full time

    The Physician is responsible for assessing and treating patients, collaborating with other healthcare professionals, providing consultations and referrals, and ensuring high-quality patient care. They work closely with the Nurse Manager- Health Services & PI and ARNPs to ensure comprehensive patient care. This position also includes on-call responsibilities...

  • Mental Health Practitioner: Psychiatrist/CNP/CNS

    22 hours ago

    Warren, Ohio, United States Axesspointe Community Health Center Full time

    Job DescriptionPosition Title: Clinical Mental Health ProfessionalDepartment/Program: Valley Counseling ServicesReports to: Medical DirectorSchedule: Determined on a case by case basisJob Summary: The Clinical Mental Health Professional will screen, diagnose, treat, and manage the mental health care of identified clients of the agency.Key...

  • RN Coordinator

    2 weeks ago

    Warren, United States Henry Ford Health System Full time

    Coordinates a centralized bed management system to facilitate efficient admissions and transfers, optimize occupancy and avoid delays in service. Responsibilities: Communicates with clinical staff to determine status of pending discharges, transfers and bed availability and plans bed assignments accordingly.| Reviews all admissions and transfers for...