RN Care Planning and Revenue Integrity Expert

4 days ago

Fairfield, Connecticut, United States Cambridge Health & Rehabilitation Center Full time
Cambridge Health & Rehabilitation Center seeks an experienced MDS Coordinator / RN Assessment Coordinator to join our dedicated team. As an integral member of our interdisciplinary team, you will play a key role in developing and implementing personalized resident care plans, ensuring the capture of clinical reimbursement for services provided. Your expertise and dedication will be valued and appreciated as you work collaboratively with both nursing needs of the aged and the chronically ill. This role offers a competitive compensation package, opportunities for career advancement, and the chance to make a meaningful difference in the lives of our residents. Estimated annual salary is around $83,250 based on location and industry standards.

The ideal candidate will have a valid State of CT RN License, advanced degree or certification, and direct care experience in a long-term care setting. You should possess knowledge of state and federal regulations governing the MDS, Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid, and Medicare requirements. Additionally, you will be a deadline-driven, detail-oriented individual with strong organizational skills, analytical capabilities, and the ability to make decisions independently. Excellent written and verbal communication and interpersonal abilities, as well as the ability to work effectively and influence others in a multidisciplinary team environment, are essential responsibilities.

Your responsibilities will include:
  • Determining Patient Driven Payment Method (PDPM) and expense associated with a potential admission
  • Participating in admitting prospective residents by assessing their nursing needs and determining appropriate clinical reimbursement levels
  • Completing and assuring the accuracy of the MDS process for all residents
  • Monitoring Case Mix Index (CMI) scores, looking for potential risks and/or changes that may affect reimbursement
  • Ensuring the highest level of revenue integrity and compliance to all state and federal regulations for MDS completion and coding conventions
  • Collaborating with interdisciplinary teams to ensure accurate data collection for assessments
  • Providing insights and ongoing education to facility staff and leaders

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