RN - Clinical Coordinator

6 days ago


Buffalo, New York, United States Elderwood Full time
About the Role

Elderwood is seeking an experienced RN to fill the position of Clinical Coordinator, specializing in MDS and long-term care. This role requires a strong understanding of assessment and reimbursement methodologies, as well as experience with Patient Driven Payment Model (PDPM) and Case Mix Index (CMI).

Key Responsibilities
  • Oversee and review MDS/PPS components of the facility's MDS/PPS departments.
  • Complete and/or oversee completion of all Medicare PPS MDS and/or OBRA assessments for both subacute and long-term care.
  • Establish schedules for completion of Medicare required assessments to maximize reimbursement and RUGs categories for each individual assessment.
  • Act as a liaison to the business office coordinator and/or designee in determining eligibility for Medicare and tracking Medicare days in the facility.
  • Serve as the facility's contact with Managed Care providers to ensure proper authorization and reimbursement for facility services provided.
Requirements
  • Licensed Professional Nurse (RN) licensure in New York State.
  • Prior experience with MDS 3.0 scheduling, coding, and submission requirements.
  • Experience with Patient Driven Payment Model (PDPM) and Case Mix Index (CMI).
  • Experience with PointClickCare preferred.
  • Excellent verbal and written communication skills.
  • Self-motivated, highly organized, and dedicated.


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