Dir. of Clinical Assessment and Reimbursement
3 weeks ago
Overview: Director of Clinical Assessment & Reimbursement will support, provide assistance and guidance to Franciscan Ministries Skilled Nursing communities MDS nurses and interdisciplinary teams. Responsibilities will include assessment accuracy, clinical analytics, Medicare billing, and adherence to industry standards following applicable state, federal and organizations policies, procedures, and regulations. The individual in this role serves as the organizational expert on PDPM, CMS Quality Measures, Medicare billing, Managed Care, Five Star analytics and PBJ.This role requires moderate travel and remote work supporting seven skilled nursing communities, four in Illinois, two in Ohio and one in Indiana. Key Duties & ResponsibilitiesOversees the MDS department across Franciscan Ministries Skilled Nursing Communities.Ensure that MDS has proper and sufficient training to ensure the best PDPM and CMI outcomes for resident’s acuity and maximize revenue.Monitor scheduling of assessments, and timeliness of MDS’s.Drive Quality Measure goals to account for the quality of care provided to residents.Ensure compliance with CMS, Medicare and federal guidelines.Assist centers in the triple check process.Implement/update policies and procedures related to reimbursement and care planning.Oversee and monitor the center’s ADR (Additional Documentation Request) processes.Ensure PBJ hours are correct and submitted per federal regulations.Monitor and ensure communities are meeting CMS QRP requirements.Assist with completion of MDS’s when needed.Train and coach new and current MDS nurses. Mission & ValuesSupports, upholds, and maintains the Mission & Philosophy of the Franciscan Sisters of Chicago and promotes it in a positive manner in all business interactions within and outside of the Demonstrates loyalty, pride in the Ministry, its associates, and departments.Respects and safeguards the confidentiality of information regarding residents, co-workers and the Community, and holds others accountable to the sameAs a leader within the organization, projects a professional and caring demeanor in interactions with residents, family members, visitors, associates, andSets an example by demonstrating an attitude of teamwork when interacting with others within or outside the community. As such, consistently displays respect for self and for others in manner (body language, dress), word (spoken language) and action (behavior).Takes ownership of job responsibilities by initiating prompt and appropriate action/follow-up in all Ensures appropriate and timely resolutions to situations.Exhibits resourcefulness and Initiative in anticipating and meeting the needs of residents, co-workers, and subordinates in a pro-active manner. Encourages and empowers subordinates to perform in the sameWelcomes feedback, suggestions, and new ideas as an opportunity to learn, grow, and improvePromotes and supports the change effort through accurate and timely communication, flexibility, and acceptance. Aligns community/departmental goals and objectives with the overall strategic plan of the organization. III. Position Requirements In addition to significant experience in the industry, the ideal candidate will show exceptional business aptitude, strategic thinking and creative abilities that reflect a unique understanding of the sector and the clients we serve. Ideal candidates will have:Licensed Registered Nurse.5+ years of experience in clinical leadership, including multi-site5+ years of experience as a Resident Assessment Coordinator.High degree ofStrong communicator and capable of managing and leadingAbility to multi-task and is able to prioritize projects and deadlines V. Essential FunctionsThis is a field-based position traveling to different communities in all operating Must be effective in functioning in a team approach regardless of the work environment.Must be able to function independently and demonstrate flexibility and personalThe Director Clinical Assessment & Reimbursement is in contact with peers, residents, associates, visitors, and family They should project a friendly caring demeanor.Ability to travel 45% of the time.Abide by the organization’s policies and General Working ConditionsGeneral office areas as well as throughout theIs subject to frequent interruptions by associates, vendors, residents, family members, andIs involved with associates, residents, visitors, government agencies/personnel, etc. under all conditions and circumstances.Maintains confidential information due to its sensitive nature and in accordance with HIPAA VII. Physical Demands of the PositionMust be able to move intermittently throughout theAbility to stand, walk, bend, andMust possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fullyMust meet the general health requirements set forth by the policies of this community, which include a medical and physical VIII. Mental Acuity Requirements of the JobMust function independently and have flexibility, personal integrity, and the ability to work effectively with the residents, personnel, and supportMust possess the ability to make independent decisions when circumstances warrant suchMust possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies / personnel, and the generalMust be knowledgeable of healthcare regulations, laws, and guidelines governing the long-term careMust possess leadership ability and willingness to work harmoniously with other personnel.Must be able to read, analyze, and interpret the most complex IX. Technical/Motor Skill Requirements of the Job Must be able to speak and write the English language in an understandableMust be able to communicate with people of all professional and socialMust be proficient in Microsoft Office and other common software application, PCC experience preferred.Must possess the ability to use general office #LivingJoyfully
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Dir. of Clinical Assessment and Reimbursement
3 weeks ago
Lemont, United States Franciscan Ministries Full timeOverview: Director of Clinical Assessment & Reimbursement will support, provide assistance and guidance to Franciscan Ministries Skilled Nursing communities MDS nurses and interdisciplinary teams. Responsibilities will include assessment accuracy, clinical analytics, Medicare billing, and adherence to industry standards following applicable state, federal...
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Dir. of Clinical Assessment and Reimbursement
3 weeks ago
Lemont, IL, United States Franciscan Ministries Full timeOverview: Director of Clinical Assessment & Reimbursement will support, provide assistance and guidance to Franciscan Ministries Skilled Nursing communities MDS nurses and interdisciplinary teams. Responsibilities will include assessment accuracy, clinical analytics, Medicare billing, and adherence to industry standards following applicable state, federal...
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Lemont, Illinois, United States Franciscan Ministries Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Director of Assessment and Reimbursement to join our team at Franciscan Ministries. As a key member of our leadership team, you will be responsible for overseeing the clinical assessment and reimbursement processes across our skilled nursing communities.Key ResponsibilitiesLeadership and...
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Lemont, Illinois, United States Franciscan Ministries Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Director of Assessment and Reimbursement to join our team at Franciscan Ministries. This is a field-based position that requires travel to different communities, and the ideal candidate will have a strong background in clinical leadership, including multi-site experience.Key...
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