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MDS Management Specialist
2 months ago
Glasgow Rehab and Care Center is seeking an MDS Management Specialist.
ROLE SUMMARY:
The MDS Management Specialist is responsible for developing and finalizing resident evaluations, care strategies, and overseeing reimbursement processes in accordance with Medicare and Medicaid regulations by executing the following responsibilities:
KEY RESPONSIBILITIES:
To successfully fulfill the essential duties, the individual must demonstrate the ability to perform each task effectively. Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions. The responsibilities listed below are indicative of the knowledge, skills, and/or abilities required. Additional duties may be assigned.
- Conducts Resident Evaluations:
Timely completion, transmission, and updates of assessments; implementation of CAAs and Triggers; evaluation of each resident's condition, medical history, and special assessment activities. Coordination of interdisciplinary meetings to review evaluations.
- Facilitates Care Plans:
Ensures the timely creation of comprehensive care plans tailored to meet the medical, nursing, mental, and psychosocial needs of each resident, including measurable objectives; conducts regular assessments and ensures care plans are updated with each evaluation or status change; coordinates timely reviews by the interdisciplinary team.
- Assists with Coverage Matters:
Completion of pre-admission assessments; coordination of Medicare and payer coverage; analysis of clinical financial issues related to the RAI process; communication of concerns to relevant staff; review of clinical and therapy documentation to ensure residents are classified in the appropriate resource utilization group (RUG) level and assist with coding; ensuring documentation aligns with Medicare charting guidelines.
- Leads Interdisciplinary Care Team:
Acts as Chairperson for the Interdisciplinary Care Plan Team, developing comprehensive resident assessments and care plans. Provides training to staff regarding the RAI process and monitors documentation to support MDS.
- Maintains Documentation Standards:
Ensures that all sections of each assessment are signed and dated by the responsible individual.
- Conducts Quality Assurance:
Performs ongoing reviews of quality concerning resident assessments and care plans; regularly audits the RAI process for accuracy and timeliness; assists with audits of the MDS process with external consultants; communicates audit results to staff.
- Coordinates Record Requests:
Manages record requests to validate payments, including notifying the interdisciplinary team, developing checklists with service dates, and ensuring timely mailing of records.
Qualifications:
Must be a Registered Nurse (RN) in the state of operation.
