MDS Coordinator: Care Quality & Compliance Lead

Diversicare; Foley (AL); On-site; USD 60,000 - 80,000; Full time

Job summary

Diversicare seeks a dedicated MDS Coordinator to manage MDS processes and regulatory compliance in a post-acute setting. You’ll work under RN guidance with an interdisciplinary team to ensure accurate coding and timely submissions for Medicare/Medicaid populations.

You will coordinate care plans, monitor quality measures, and provide education on the RAI process while staying current with regulatory guidelines and data submission requirements.

Qualifications

• Current nursing license in the state of employment.
• Experience in Long Term Care.
• Knowledge of Medicare, Managed Care, and the RAI process.
• Participation in LPN to RN Back to School transition program.

Responsibilities

• Facilitates the RAI Process under the direction of an RN or DNS2.
• Collaborates with the interdisciplinary team to identify the needs of the patient/resident.
• Coordinates and conducts the daily Case Management meeting.
• Ensures timely MDS assessments according to state and federal regulations.
• Ensures interdisciplinary team completes designated sections of the MDS assessment.
• Ensures accurate coding of the MDS assessment from medical records, observations, and interviews.
• Maintains tracking of MDS assessment schedules.
• Facilitates Care Plan conferences with the team, patient, residents and families.
• Obtains and reviews State and Federal reports, making timely corrections.
• Monitors Quality Measures and ensures MDS accuracy to support measures.
• Provides education related to the RAI Process.
• Coordinates electronic submission of required documentation per guidelines and regulations.
• Ensures Medicare and Medicaid regulatory guidelines are completed accurately and timely.
• Provides Managed Care case management at the center level.
• Reviews Additional Documentation Requests with HIMC to ensure documents are available.
• Participates in billing reviews to support claims with MDS documentation.
• Participates in Quality Assurance and Process Improvement.
• Keeps knowledge base updated on Medicare, Managed Care, Medicaid, RAI Process, and tech updates.
• May fulfill direct care nurse duties as needed.

Skills

Computer skills

Medicare knowledge

RAI process knowledge

Job description

Diversicare seeks a dedicated MDS Coordinator to manage MDS processes and regulatory compliance in a post-acute setting. You’ll work under RN guidance with an interdisciplinary team to ensure accurate coding and timely submissions for Medicare/Medicaid populations.

You will coordinate care plans, monitor quality measures, and provide education on the RAI process while staying current with regulatory guidelines and data submission requirements.