MDS Nurse Specialist

7 days ago


Hudson, Ohio, United States Hudson Elms Nursing Home Full time
Job Title: MDS Nurse Specialist

Hudson Elms Nursing Home is seeking a highly skilled MDS Nurse Specialist to join our team. As a key member of our healthcare team, you will be responsible for coordinating and monitoring Medicare, Managed Care, and Medicaid revenue at our facility.

Key Responsibilities:
  • Coordinate and monitor Medicare, Managed Care, and Medicaid revenue at the facility.
  • Ensure residents receive optimal skilled services to meet their needs for independent function and potential discharge to the community.
  • Monitor facility Quality Measures, identify issues, and assist with corrective actions to improve overall quality services.
  • Provide education and assistance to facilities on Medicare/Medicaid-related areas, including eligibility, certification, coverage, documentation, utilization, and reimbursement.
  • Interact with Medicare, Managed Care, and Medicaid claims review units and compliance units to assist facilities in complying with company procedures and federal, state, and local regulations.
  • Establish and maintain current statistical data associated with the Medicare, Managed Care, and Medicaid programs by region.
  • Monitor and identify utilization issues, establish systems to maximize utilization and reimbursement, and provide training and recommendations to enhance therapy utilization.
Requirements:
  • Two years of experience in Medicare/Medicaid areas in long-term care or clinical training.
  • Excellent communication and teaching skills in both individual and group settings.
  • Ability to maintain regular attendance and be available to travel, including overnight travel as required.
  • Working knowledge of MDS 3.0, care plans, care guides, and the CMI reimbursement process.


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