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MDS Nurse Coordinator
2 months ago
As a key member of our healthcare team, the MDS Nurse Coordinator plays a vital role in overseeing the Resident Assessment Instrument (RAI) process. This position is essential for ensuring that resident assessments are completed accurately and promptly, adhering to the requirements set forth by Medicare, Medicaid, and other regulatory bodies.
Core Responsibilities
- Coordinate the comprehensive assessment of residents' health and functional status throughout the assessment period.
- Engage in the pre-admission process to gather critical information necessary for optimizing MDS/Case Mix.
- Ensure timely and precise completion of all Medicare/Medicaid documentation to secure appropriate reimbursement for services rendered.
- Collaborate with the Director of Rehabilitation to determine the most suitable Assessment Reference Date (ARD) for evaluations.
- Monitor Skilled customers using Case Management Tools to assess ongoing Medicare/Managed Care eligibility.
- Collect data for Managed Care Utilization Reviews and communicate findings with relevant Case Managers.
- Adhere to Medicare Program requirements, including physician certifications and re-certifications.
- Conduct concurrent MDS reviews to ensure accurate RUGs categorization.
- Participate in interdisciplinary team meetings to enhance care plan development and management.
- Maintain a detailed schedule of MDS assessments, ensuring compliance with RAI guidelines.
- Analyze default days and implement corrective actions as necessary.
- Perform audits of the MDS process to validate coding and evaluate outcomes.
- Ensure timely electronic submission of Minimum Data Sets and manage backup personnel for this process.
- Review validation reports and address any discrepancies promptly.
- Communicate regularly with management regarding reimbursement impacts and case mix index.
- Engage in various departmental meetings to support operational efficiency.
- Serve as a resource for RAI and Care Management processes within the facility.
- Facilitate training for new staff on RAI processes and regulatory updates.
Additional Duties
- Manage daily operations within the department while maintaining current knowledge of reimbursement regulations.
- Organize data for easy retrieval and maintain professional standards.
- Demonstrate excellent interpersonal skills and work collaboratively within a team environment.
- Adapt to flexible work hours as required by business needs.
- Perform other duties as assigned.
Qualifications
- Graduate of an accredited nursing program with a current RN or LVN license.
- Completion of all required MDS/RUGs training modules within the initial employment period.
- Proficiency in standard office software and MDS/RAI-related applications.
- Minimum of two years of healthcare experience, with a preference for candidates with MDS and case management expertise.
Physical Requirements
The physical demands of this role include effective communication and the ability to perform essential functions with or without reasonable accommodations. Candidates should be prepared for a range of physical activities associated with nursing duties.
Equal Opportunity Employer
Regency Integrated Health Services is committed to diversity and inclusion in the workplace. We do not discriminate based on race, religion, gender, or any other protected status.
