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Director of Clinical Operations

2 months ago

East Hartford Connecticut, United States Riverside Health & Rehabilitation Center Full time
About the Role

Riverside Health & Rehabilitation Center is seeking a highly skilled and experienced MDS Director to lead our Minimum Data Set (MDS) program. As a key member of our clinical team, you will be responsible for ensuring the highest level of revenue integrity and compliance with state and federal regulations.

Key Responsibilities
  • Lead and oversee the MDS program, ensuring compliance and accuracy in assessments
  • Determine Patient Driven Payment Method (PDPM) and expense associated with a potential admissions
  • Monitor Case Mix Index (CMI) scores, looking for potential risks and/or changes that may affect reimbursement
  • May train, mentor and/or manage MDS Coordinators, providing guidance and support
  • Coordinate and participate in comprehensive resident assessments and care planning
  • Collaborate with interdisciplinary teams to ensure accurate data collection for assessments
  • Provide insights and ongoing education to facility staff and leaders
  • Track, trend and analyze assessment data to confirm compliance and identify strategic opportunities to optimize reimbursement
  • Drive a culture of continuous improvement and innovation in nursing care
Requirements
  • Valid state RN license preferred
  • Advanced degree or certification preferred
  • Direct care in a long-term care setting and/or MDS Coordinator experience required
  • Proficient in state and federal regulations governing the MDS and billing process
  • Knowledge and understanding of Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements
  • Interest in the nursing needs of the aged and the chronically ill with the ability to work with both
  • Deadline driven, exceptionally detail-oriented individual with strong organizational skills, analytical capabilities and the ability to make decisions independently
  • Excellent written and verbal communication and interpersonal abilities
  • Ability to work effectively and influence others in a multidisciplinary team environment