Job description

POSITION SUMMARY

Responsible for the coordination of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments, in accordance with Medicare, Medicaid, OBRA and other payer program requirements. Ensures MDS assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures appropriate documentation to support services provided.

PRINCIPAL DUTIES AND RESPONSIBILITIES

• Have a thorough understanding of all regulations and standards related to the RAI process (Federal/State regulations and MDS RAI User Manual).
• Completion of the RAI process and management of the MDS department.
• Work in collaboration with the IDT to ensure accurate and timely completion of all Medicare documents in order to maintain regulatory compliance within the community. To include but not limited to: Physician certification/ recertification, NOMNC, SNF ABNs, ABNs, and Letter of medical predictability.
• Work in collaboration with the facility Director of Rehab to ensure the most appropriate assessment reference date (ARD) and assessment type/combination are utilized for Medicare/Managed Care PPS Assessments.
• Work in collaboration with the Director of Nursing to ensure necessary nursing documentation and risk assessments are completed in order to code nursing services delivered on the MDS.
• Chair the weekly utilization review meeting in accordance with any Paramount guidance, policy and procedures, in absence of Director of MDS.
• Demonstrate an understanding and assisting in the preparation of clinical, quality and reimbursement reports.
• Participate in the pre-admission process to ensure essential information needed for MDS/Case Mix coding is obtained from the referral source(s) and meets Medicaid eligibility requirements when applicable.
• Participate in month end Triple Check, daily PPS meeting and other meetings per ASL policy.
• Participate in the preparation and timely submission of any Additional Documentation Requests (ADRs).
• Participate in the community orientation.
• Participate in the training of new associates on the RAI process.
• Provide ongoing training/education to staff regarding RAI process to included but not limited to: ADL training, interview techniques, skilled services and documentation guidelines.
• Ensures timely, accurate, and complete assessment of the residents’ health and functional status during the entire assessment period.
• Accurately code MDS to reflect services delivered per RAI guidelines. Ensures the accurate and timely completion of all MDS assessments.
• Ensures individualized plans of care with interdisciplinary approach in accordance with federal, state and local regulations and the established policies and procedures of Paramount.
• Reviews the validation reports and ensures that appropriate follow-up action is taken.
• Analyzes Quality Measure reports as a mechanism of quality assurance.
• Functions as an RAI and Clinical Reimbursement resource to the community staff.
• Attends and participates in education, such as but not limited to: ASL webinars, ASL meetings, RAC-CT, ADL training, and community training.
• Maintains proficiency in the operations of the clinical/MDS software program.
• Maintains proficiency in the ability to transmit data per regulatory standards.
• Maintains confidentiality of pertinent client and employee information to assure their privacy is protected.
• Participates in the review of quarterly Medicaid reports.
• Supports and upholds all Paramount policies and procedures.
• Other duties as assigned.

EDUCATION AND/OR EXPERIENCE

• MDS 3.0 experience required
• Progressive experience in a long term care setting preferred

CERTIFICATES, LICENSES, REGISTRATIONS

• Graduate of an accredited school of nursing with a current RN/LVN s
• RAC-CT or willingness to obtain within 6 months of hire and maintain recertification as required

KNOWLEDGE, SKILLS AND ABILITIES

• Must possess strong collaborative, interpersonal, organizational, multi-tasking, verbal and written communication skills, and a desire to create a high-performance, effective team that can produce consistent, demonstrated results.
• Must demonstrate on an ongoing basis the ability to develop and maintain good working relationships with co-workers and ministry leadership.
• The incumbent must demonstrate the ability to communicate clearly and concisely on oral and written form.
• Competencies needed for this position include strong interpersonal relationship skills, detail oriented, work in collaboration with others, demonstrate a high degree of integrity and personal commitment, possess strong analytical skills, be able to work independently and manage multiple deliverables at the same time.
• Ability to function in a matrix environment and demonstrate a passion to succeed be self- motivated, dependable, committed, and a willingness to see a project through to its conclusion.
• Working knowledge and proficiency with Microsoft Office is required.
• Ability to work independently, to organize work and maintain good time management skills.
• Must have initiative and judgment in assigning tasks, and resolving operational problems.
• Extremely organized, accurate, and precise
• The ability to work flexible hours as required
• Makes mature judgments, functions independently, is flexible, has personal integrity and works effectively with personnel.
• Knowledgeable of the rules and regulations related to the MDS/RAI process and Medicare-A skilled nursing services, Managed Care and Medicaid.

Job Type: Full-time

Experience:

• MDS Coordinator: 2 years (Required)

License:

• LVN/LPN/RN (Required)

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Physical setting:

• Nursing home

Schedule:

• Monday to Friday
• Weekend availability

Ability to commute/relocate:

• El Paso, TX 79902: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Utilization review: 1 year (Preferred)

License/Certification:

• RN (Preferred)

Work Location: One location

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Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Physical setting:

• Nursing home

Schedule:

• Day shift
• Monday to Friday
• Weekend availability

Ability to commute/relocate:

• Lubbock, TX 79410: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Utilization review: 1 year (Preferred)

License/Certification:

• RN (Preferred)

Work Location: One location

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Job Types: Full-time, Part-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday
• Weekend availability

Ability to commute/relocate:

• Ruston, LA 71270: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Utilization review: 1 year (Preferred)

License/Certification:

• RN (Preferred)

Work Location: One location

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