Case Mix Coordinator

PruittHealth; Raleigh (NC); On-site; USD 80,000 - 100,000; Full time

Job summary

PruittHealth – Raleigh is seeking an experienced RN to serve as MDS Coordinator. This role focuses on resident assessments, care planning, and ensuring regulatory compliance while optimizing reimbursement processes.

The coordinator will partner with an interdisciplinary team to maintain accurate clinical documentation and drive quality outcomes. Strong MDS/PDPM knowledge and EMR proficiency are essential.

Qualifications

• Active RN license in NC is required.
• Strong MDS/RAI/PDPM knowledge.
• Solid documentation and communication skills.
• Ability to manage multiple priorities and meet deadlines.

Responsibilities

• Coordinate and complete MDS assessments per federal/state regulations.
• Ensure accurate, timely, compliant clinical documentation.
• Collaborate with interdisciplinary team on assessments and care planning.
• Monitor quality measures, clinical outcomes, and reimbursement opportunities.
• Review clinical records to support resident care and reimbursement needs.
• Support Medicare/Medicaid/PDPM and payer documentation processes.
• Assist with survey readiness, regulatory compliance, and quality improvement initiatives.

Skills

MDS knowledge

PDPM knowledge

Documentation skills

Regulatory compliance

Interdisciplinary teamwork

Education

RN license (NC)

Tools

EMR systems

MDS software

Job description

Job Description - Case Mix Coordinator (2613753)

Description

REGISTERED NURSE (RN) – MDS COORDINATOR

Address: 2420 Lake Wheeler Rd, Raleigh, 27603

Facility Name: PruittHealth - Raleigh

Join the PruittHealth Family

PruittHealth is seeking an experienced Registered Nurse (RN) – MDS Coordinator to support resident assessments, care planning, reimbursement processes, and quality outcomes. In this role, you'll work closely with interdisciplinary teams to ensure accurate clinical documentation, regulatory compliance, and resident-centered care.

If you're passionate about MDS, clinical excellence, and improving resident outcomes, we invite you to join the PruittHealth family.

Why Join PruittHealth?

• Career Growth & Development Opportunities

Responsibilities

• Coordinate and complete MDS assessments in accordance with federal and state regulations
• Ensure accurate, timely, and compliant clinical documentation
• Collaborate with interdisciplinary team members on resident assessments and care planning
• Monitor quality measures, clinical outcomes, and reimbursement opportunities
• Review clinical records to ensure documentation supports resident care and reimbursement requirements
• Support Medicare, Medicaid, PDPM, and payer-related documentation processes
• Assist with survey readiness, regulatory compliance, and quality improvement initiatives

Qualifications

• Current Registered Nurse (RN) license in the state of practice
• Strong clinical assessment, documentation, and communication skills
• Knowledge of MDS, RAI process, PDPM, and reimbursement methodologies
• Ability to manage multiple priorities and meet deadlines

Preferred Qualifications

• Experience as an MDS Coordinator, MDS Nurse, Case Mix Coordinator, RAI Coordinator, or Clinical Reimbursement Coordinator
• Experience in Skilled Nursing, Rehabilitation, Long-Term Care, or Post-Acute Care
• Knowledge of Medicare, Medicaid, PDPM, quality measures, and reimbursement systems
• Experience with Electronic Medical Records (EMR) and MDS software systems

Family Makes Us Stronger.

Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

At PruittHealth, we’re committed to supporting our residents and the healthcare professionals who care for them. Join a team built on compassion, respect, teamwork, and excellence.

As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.