RN/LVN Patient Care Assessment Specialist, Clinical Operations Manager
1 week ago
We are seeking an experienced Patient Care Assessment Specialist to join our team at Regency Integrated Health Services. As a key member of our interdisciplinary team, you will be responsible for coordinating the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA, and other payer program requirements.
About the Role- Coordinate RAI process to ensure accurate and timely completion of resident assessments
- Ensure assessments accurately reflect the physical, mental, and psychosocial status of each resident
- Communicate effectively with other members of the interdisciplinary team
- Maintain current knowledge of reimbursement regulations
- Collaborate with the facility Director of Rehab to ensure the most appropriate assessment reference date (ARD) is utilized for Medicare/Managed Care Assessments
Timely, accurate, and complete assessment of the resident's health and functional status during the entire assessment period
Participate in the pre-admission process to ensure essential information needed for MDS/Case Mix optimization is obtained from the referral source(s)
Accurate and timely completion of all Medicare/Medicaid case-mix documents to assure appropriate reimbursement for services provided within the facility
Work in collaboration with the facility Director of Rehab to ensure the most appropriate assessment reference date (ARD) is utilized for Medicare/Managed Care Assessments
Track Skilled (MRA/MCO/MCG/MMP) customers utilizing Case Management Tools to determine continued and appropriate Medicare/Managed Care eligibility and benefit period through regular communications with Regional Care Management Specialist, Business Office, and external Case Managers
Gather information needed for Managed Care Utilization Reviews throughout the resident's stay and communicate this with the Managed Care organization's Case Manager as required
Ensure that additional requirements of the Medicare Program are met, such as Physician certification and re-certification
Perform concurrent MDS review to assure appropriate RUGs category is achieved through the capture of appropriate clinical information
Participate in the interdisciplinary team process to communicate opportunities, facilitate efficient and effective care plan development and management
Ensure the accurate and timely completion of all MDS assessments including PPS, Unscheduled, Admission, Quarterly, Annual, and Significant Change in compliance with RAI guidelines
Collaborate with the interdisciplinary team to identify significant change in status and implementation of Significant Change in Status MDS
Maintain an accurate schedule of all MDS assessments to include the proper reference dates throughout the resident's stay
Tracks, records, and analyzes all default days and rectifies if appropriate. Implements corrective action to prevent further default action
Perform Modification/Inactivation of assessments in accordance with CMS Correction Policy and collaboration with Regional Care Management Specialist
Conduct regular audit of MDS process including validation of coding documentation, evaluating outcomes, and utilization of Data Integrity Audit reports (Point Right) per company policy
Ensure the timely electronic submission of all Minimum Data Sets and secure backup personnel to complete this process
Reviews the Validation reports and ensures that appropriate follow-up action is taken
Reviews Late/Missed assessment reports monthly and addresses issues as appropriate
Reviews QM and SNF QRP reports monthly and ensures that appropriate follow-up action is taken
Communicate with the Business Office Manager and Administrator on a regular basis regarding RUG distribution, default days/unassigned days, case mix index (if applicable), and their reimbursement impact
Participate in daily Case Management, weekly Level of Care, monthly Triple Check, and other meetings per RIHS policy. Assist in the preparation and timely submission of any Additional Development Requests (ADRs), Reconsideration, and Administrative Law Judge (ALJ)
Function as an RAI and Care Management resource to the facility staff
Utilize AIS as annual competency training as well as for educational resource as needed
Assist in the orientation and training of new associates on the RAI process and ensure the dissemination of any new or updated materials regarding the RAI and/or Federal and State regulations
The Care Management Specialist manages the day-to-day operations of the department
Maintains current knowledge of reimbursement regulations
Maintains data in an organized, easily retrievable manner
Maintains good personal hygiene and follows dress code requirements
Communicates regularly with the Regional Care Management Specialist to discuss identified clinical reimbursement issues
Ability to work flexible work hours to support business requirements
Ability to utilize both local and corporate resources in the execution of job responsibilities
Must possess superior clinical assessment and documentation skills
Must demonstrate strong interpersonal skills and ability to work well in a team environment
Other duties as assigned or needed
- Analytical reasoning
-
Personalized Patient Care Specialist
7 days ago
Austin, Texas, United States Aveanna Healthcare Full timeAveanna Healthcare is a leading national provider of home health services to medically fragile children and adults. As a Personalized Patient Care Specialist - LPN/LVN, you will play a vital role in delivering high-quality, patient-centered care in the comfort of our patients' homes.Job SummaryProvide skilled nursing care to patients under the supervision of...
-
Home Health Clinical Specialist
7 days ago
Austin, Texas, United States AccentCare Full timeAbout the RoleWe are seeking a compassionate and skilled Home Health LPN/LVN to join our team at AccentCare. As a clinical specialist, you will play a vital role in providing high-quality patient care and support.Responsibilities:Provide professional nursing care to patients in their homes, ensuring a safe and comfortable environment.Conduct thorough...
-
Nurse - Patient Care Specialist
1 week ago
Austin, Texas, United States Aveanna Full timeJob DescriptionWe are seeking a skilled and compassionate Nurse - Patient Care Specialist to join our team at Aveanna Healthcare. As a Licensed Practical Nurse (LPN/LVN), you will play a vital role in delivering high-quality patient care in the comfort of their own homes.About the Role:Provide skilled nursing care to patients with complex medical needs,...
-
Dialysis Clinic Operations Manager RN
4 days ago
Austin, Texas, United States Fresenius Medical Care Full timeAbout Fresenius Medical CareAt Fresenius Medical Care, we are dedicated to providing exceptional patient care and improving the lives of individuals with kidney disease.We are seeking a highly skilled Dialysis Clinical Manager Registered Nurse to join our team. As a key member of our leadership team, you will be responsible for ensuring the delivery of...
-
Austin, Texas, United States Regency Integrated Health Services Full timeJob SummaryThe Clinical Assessment and Reimbursement Specialist will play a crucial role in ensuring the accuracy and timeliness of resident assessments, while also managing the reimbursement process for Medicare/Medicaid cases. This position requires strong clinical assessment and documentation skills, as well as excellent communication and interpersonal...
-
Personal Care Specialist LVN
7 days ago
Austin, Texas, United States Aveanna Healthcare Full timeWe are seeking a compassionate Licensed Practical Nurse (LPN/LVN) to join our team at Aveanna Healthcare, providing skilled nursing care in the comfort of patients' homes. This role requires dedication, attention to detail, and effective communication skills to deliver high-quality patient care.About UsAveanna Healthcare is a leading national provider of...
-
Clinical Care Nurse
7 days ago
Austin, Texas, United States LanceSoft Full timeJob SummaryAs a Clinical Care LVN/LPN with LanceSoft, you will be empowered to deliver holistic patient care to your community with support, guidance, collaboration, and a "one store, one team mindset."Our LPNs/LVNs enjoy great patient workloads with a 1 on 1 patient ratio, fully utilizing their nurse skillset through our expanded practice, playing an...
-
Neuropsychological Assessment Specialist
3 days ago
Austin, Texas, United States AUSTIN CENTER FOR THERAPY AND ASSESSMENT Full timeAUSTIN CENTER FOR THERAPY AND ASSESSMENT is seeking a qualified Neuropsychological Assessment Specialist to join our team.**Job Summary:**We are looking for an experienced professional to provide neuropsychological and psychological assessment services for children and adults under the supervision of our staff neuropsychologists. This role involves...
-
Healthcare Operations Manager
1 week ago
Austin, Texas, United States Brookdale Senior Living Full timeAbout Brookdale LakewayBrookdale Senior Living, a leading provider of senior living solutions, is seeking an experienced LPN/LVN Supervisor to join our team at Brookdale Lakeway in Lakeway, Texas.OverviewWe are proud to have been voted one of America's Greatest Workplaces for Diversity by Newsweek in 2024. Our commitment to diversity and inclusion sets us...
-
Critical Care Nurse Specialist
6 days ago
Austin, Texas, United States Encompass Health Corp Full timeEncompass Health Corp is seeking a Critical Care Nurse Specialist to join our team. About the RoleThis is a critical role that requires a dedicated and experienced Registered Nurse to provide direct patient care to inpatients. As a Critical Care Nurse Specialist, you will assess patients and create a personalized plan of care that reflects each patient's...
-
Private Duty Nurse
1 week ago
Austin, Texas, United States Aveanna Healthcare Full timeAveanna Healthcare is a leading national provider of home health services to medically fragile children and adults. We are committed to revolutionizing the way homecare is delivered, one patient at a time.Job OverviewWe are seeking compassionate nurses in various areas to join our team as Private Duty Nurses - LVN/LPN Home Health Specialists. As an essential...
-
Patient Care Associate
3 days ago
Austin, Texas, United States Ascension Full timeAscension Living Community is a place where seniors can live healthier and happier at every age and stage.We are committed to providing personalized care, exceptional services, cultural opportunities, and support so our residents can enjoy living in a beautiful community with city comforts.As a Healthcare Support Specialist at Ascension Seton Specialty Care...
-
Healthcare Professional
5 days ago
Austin, Texas, United States Encompass Health Corp. Full timeWe are seeking a highly skilled Registered Nurse to join our team at Encompass Health Corp.Job Summary:The Registered Nurse provides direct patient care to inpatients, assessing patients and creating a plan of care that is individualized and reflective of each patient's needs and goals.This role supervises activities of care, treatment, and services...
-
Austin, Texas, United States Aveanna Healthcare Full timeCompany Overview:Aveanna Healthcare is a leading national provider of home health services to medically fragile children and adults. Our mission is to revolutionize the way homecare is delivered, one patient at a time.About the Role:We are seeking a compassionate Licensed Practical Nurse (LPN/LVN) to join our team in providing high-quality care to patients...
-
Healthcare Compliance Specialist
6 days ago
Austin, Texas, United States Touchstone Communities Full timeAt Touchstone Communities, we are dedicated to delivering exceptional healthcare services to our patients and residents. As a Healthcare Compliance Specialist, you will play a vital role in ensuring that our skilled nursing facilities meet the highest standards of regulatory compliance.We are seeking an experienced RN/LVN with strong knowledge of clinical...
-
Clinical Compliance Specialist
5 days ago
Austin, Texas, United States Touchstone Communities Full timeJob Summary">MDS Coordinator position available at Touchstone Communities. As a skilled nurse, you will be responsible for coordinating Minimum Data Set assessments in accordance with state and federal regulations. This role requires strong knowledge of clinical and financial regulations related to skilled nursing facilities, combined with experience in case...
-
Renal Care Operations Manager
1 week ago
Austin, Texas, United States Fresenius Medical Care Full timeJoin Fresenius Medical Care, a leader in healthcare solutions, as a Clinical Manager Registered Nurse. This role offers a unique opportunity to make a meaningful difference in the lives of patients with end-stage renal disease or chronic kidney disease.About Fresenius Medical CareWe are a close-knit, collaborative team dedicated to delivering high-quality...
-
Mental Health Professional
7 days ago
Austin, Texas, United States AUSTIN CENTER FOR THERAPY AND ASSESSMENT Full timeAUSTIN CENTER FOR THERAPY AND ASSESSMENT is seeking a highly skilled and compassionate Licensed Clinical Psychologist to join our team.OverviewWe are committed to providing exceptional care to individuals with complex mental health needs, and we need an experienced professional to help us achieve this goal. As a psychologist at our center, you will play a...
-
LPN/LVN Spine Specialist
1 week ago
Austin, Texas, United States Ascension Health Full timeAscension Seton is seeking a Licensed Practical/Vocational Nurse (LPN/LVN) to join our Spine & Scoliosis Clinic team. As an LPN/LVN, you will provide care to patients under the direction of a registered nurse or physician, functioning within the scope of your license.About This OpportunityThis role offers a rewarding career in healthcare with opportunities...
-
Austin, Texas, United States Fresenius Medical Care Full timeAt Fresenius Medical Care, we are seeking an experienced Healthcare Operations Manager to lead our team in providing high-quality care to patients with chronic dialysis needs.Job SummaryThe Healthcare Operations Manager will oversee the daily operations of our clinic, ensuring that all aspects of patient care meet the highest standards. This includes...
