The RN - MDS Coordinator will play a crucial role in ensuring accurate and timely completion of Minimum Data Set (MDS) assessments, collaborating with interdisciplinary teams to enhance resident care plans, and maintain compliance with regulatory requirements. Identifies resident acuity and needs, helping to determine specific care needs, and coordinates interdisciplinary care planning schedule and process.

Core Job Responsibilities

Coordinates completion of the MDS assessment process with the appropriate participation from other health care professionals according to CMS guidelines. Collaborates with the interdisciplinary team to develop individualized care plans based on MDS assessments.
Schedules required MDS updates with care team, checks for completion and submits to CMS. Checks CMS reports to ensure submissions are complete.
Creates care conference schedules and care plan schedules to ensure timely interdisciplinary care planning meetings, and to establish assessment reference period to assure accurate assessments.
Tracks insurance dates. Schedules end of Medicare MDS when appropriate. Notifies billing, interdisciplinary care team and pharmacy of any changes.
Monitors for any resident changes in condition that may change scores to increase reimbursement.
Ensures completion of daily Medicare documentation and Medicare (re)certifications.
Initiates and monitors appeals to Livanta.
Prepares CMI (Case Mix Index) calculations and certifications for the State.
Reviews and prepares QAPI reports from iQIES and CASPER.
Evaluates care programs and initiates changes as necessary to ensure compliance with regulatory requirements.
Communicates State and Federal regulatory revisions to facility management to maintain awareness/compliance.
Performs audits, analyzes data and assists with plan of action to correct identified deficiencies.
Reviews/analyzes QI/QM data for trends and indicators of negative outcome and initiates corrective action.
Coordinates the processing of Medicare determination to assure timely and accurate billing of resident accounts.
Consults with other departments as appropriate to collaborate in resident care, risk management and quality management activities.
Provides education to staff on MDS/PRI and care planning.
Assures that resident rights to fair and equitable treatment, self-determination, individuality, privacy, property, and civil rights, including the right to wage a complaint, are well established and maintained at all times.
Attends and participates in workshops, seminars, etc. to keep current in MDS related best practices.
Performs related duties as assigned.

Education/Experience Requirements

REQUIRED:

Three (3) or more years of clinical experience in an acute or long term care care setting.
Strong understanding of MDS processes, regulations, and reimbursement systems (RUGS and PDPM).
Excellent communication and interpersonal skills.
Ability to interpret financial and statistical reports.
Highly proficient with MS Office, databases, medical software and the ability to learn new applications rapidly.

PREFERRED:

Three (3) years of experience working as a MDS/PRI assessor.
Two (2) or more years of management experience in the health care field.
Ability to read, write and speak in other languages.

Licensure/Certification Requirements

REQUIRED:

Meets RN licensure as outlined by current State Registered Nurse Licensure.
Certified as a Resident Assessment Coordinator (RAC) and PRI assessor or otherwise will obtain certification within the first 3 months of hire.
BLS certification.

Disclaimer

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Successful candidates might be required to undergo a background verification with an external vendor.

Job Details

Req Id 91619
Department UTILIZATION SERVICES
Shift Days
Shift Hours Worked 8.00
FTE 1
Work Schedule SALARIED GENERAL
Employee Status A1 - Full-Time
Union Non-Union
Pay Range $66,000 - $106,000 Annually

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