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Clinical Care Coordinator
2 months ago
We are seeking a highly skilled and dedicated Clinical Care Coordinator to join our team at Afton Oaks Nursing & Rehab Center. As a Clinical Care Coordinator, you will play a critical role in ensuring the highest level of care for our patients and residents.
Key Responsibilities- Facilitate the Resident Assessment Instrument (RAI) process under the direction of a Registered Nurse or Director of Nursing Services.
- Collaborate with the interdisciplinary team to identify the needs of patients and residents.
- Coordinate and conduct daily Case Management meetings.
- Ensure timely completion of Minimum Data Set (MDS) assessments according to state and federal regulations.
- Ensure accurate coding of MDS assessments with information obtained via medical record review, observation, and interview with center staff, patients, residents, and family members.
- Maintain accurate documentation to support MDS assessment coding.
- Track MDS assessment schedules, including timeframes and due dates.
- Facilitate Care Plan conferences with the interdisciplinary team, patients, residents, and families.
- Monitor Quality Measures and ensure MDS assessments accurately reflect Quality Measures.
- Provide education related to the RAI process.
- Coordinate electronic submission of required documentation to state databases and other entities per company guidelines and state and federal regulations.
- Ensure accurate completion of Medicare and Medicaid regulatory guidelines, including certifications, denial letters, skilled documentation, coverage criteria, etc.
- Provide Managed Care case management at the center level.
- Review Additional Documentation Requests (ADRs) with the Health Information Management Coordinator to ensure all documents are available and meet the request.
- Participate in billing reviews (Triple Check) to ensure claims have supporting MDS assessment documents.
- Participate in Quality Assurance and Process Improvement Activities.
- Stay up-to-date on knowledge related to Medicare, Managed Care, Medicaid, RAI process, and computer technology updates.
- May be required to fulfill the job functions of a direct care nurse as determined by the needs of patients and residents and center.
- Current nursing license in the state of employment.
- Experience in Long Term Care.
- Computer skills.
- Knowledge of Medicare, Managed Care, and RAI process required.
- Participation in the LPN to RN Back to School transition program.
Afton Oaks Nursing & Rehab Center is committed to being an equal opportunity employer. We do not discriminate in employment opportunities or practices on the basis of race, color, religion, sex (including gender identity), national origin, age, or disability, sexual orientation, citizenship, marital status, veteran status, genetic information, or any other characteristic protected by law.
