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Medicare Nurse Case Manager
2 months ago
The Medicare Nurse Case Manager will coordinate the nursing aspect of the Medicare program, ensuring an effective Medicare program. This role involves screening for skilled care, pre-admissions, admissions, nursing documentation, and evaluations for continued stay.
Responsibilities:- Makes rounds of Medicare patients at least daily.
- Works closely with admissions to assess all inquiries for possible Medicare admissions.
- Screens all new admits and readmissions for skilled care in accordance with facility policies and procedures.
- Responsible for skilled nursing documentation on Medicare patients, either through actual documentation or audits.
- Assesses Medicare residents for continued stay on a continuous basis and tracks remaining days in unit.
- Manages and collaborates with the MDS Team on pre-admission screening, assignment of observation and look-back periods.
- Assigns the admission RUG category for payment for the initial five-day Medicare MDS in collaboration with the MDS Team.
- Establishes individual MDS schedules and coordinates assessment activities across clinical disciplines for each patient following regulatory requirements.
- Ensures the MDS's are encoded, edited, locked, and electronically transmitted within the required time frames.
- Initiates and coordinates patient discharge plan upon admission to the facility in collaboration with the social services, admissions, clinical team, patient, and facility.
- Current State Nurse Licensure.
- Ability to read and communicate effectively in English.
- Additional languages preferred.
- Current nursing assessment knowledge.
- Ability to develop plans of care.
- Ability to document patient care outcomes.
- Basic computer knowledge.
- Ability to organize and implement MDS and plan of care schedules.
- Ability to drive and possess a valid/current driver's license.
- Use of full range of body motion including standing, walking, bending, stooping, lifting, handling, and manual dexterity.
Must work throughout all areas of the facility. Works primarily on Medicare unit but as job demands. May require working irregular hours and may be exposed to communicable diseases and/or body fluids, medical preparations, toxic substances, and occasionally ionizing radiation.
