MDS COORDINATOR - RN (84310)

Regency Integrated Health Services; Bastrop (TX); On-site; USD 60,000 - 80,000; Full time

Job summary

Regency Integrated Health Services is seeking a Full Time Nurse at Bastrop Lost Pines Nursing and Rehabilitation Center in TX. Responsibilities include coordinating the Resident Assessment Instrument process, ensuring accurate and timely assessments in accordance with healthcare regulations, and communicating effectively with an interdisciplinary team.

The ideal candidate should be a graduate of an accredited nursing school with a valid RN or LVN license and must have a minimum of two years of healthcare experience.

Qualifications

• Minimum of two years health care experience.
• Experience with MDS completion, reimbursement, clinical resource utilization, and/or case management is desirable.
• Licensure in the state of employment.

Responsibilities

• Coordinate the Resident Assessment Instrument (RAI) process to ensure accurate completion.
• Communicate effectively with the interdisciplinary team.
• Ensure timely completion of all MDS assessments in compliance with RAI guidelines.

Skills

Analytical reasoning

Logical reasoning

Problem solving

Time management

Organizational skills

Research skills

Language skills

Excellent verbal and written communication and presentation skills

Education

Graduate of an accredited school of nursing with current R.N. or L.V.N. licensure

Completion of RIHS-specific MDS/RUGs training modules within the first 90 days

Tools

Standard office software

MDS/RAI-related software

Job description

Overview

Job Location: Bastrop Lost Pines Nursing and Rehabilitation Center - Bastrop, TX 78602

Position Type: Full Time

Job Category: Nurse

Responsibilities

• Coordinate 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.
• Ensure assessments reflect the physical, mental, and psychosocial status of each resident and that documentation supports services provided and assessment accuracy.
• Communicate effectively with other members of the interdisciplinary team.
• Follow RIHS policies and procedures.
• Ensure timely, accurate, and complete assessment of the resident’s health and functional status during the entire assessment period.
• Participate in the pre-admission process to obtain essential information needed for MDS/Case Mix optimization from referral sources.
• Ensure accurate and timely completion of Medicare/Medicaid case-mix documents to support appropriate reimbursement.
• Collaborate with the facility Director of Rehab to determine the most appropriate assessment reference date (ARD) for Medicare/Managed Care Assessments.
• Track eligible cases and communicate with Regional Care Management Specialist, Business Office, and external Case Managers to determine continued eligibility and benefit periods.
• Gather information for Managed Care Utilization Reviews and communicate with the Managed Care organization’s Case Manager as required.
• Meet additional Medicare Program requirements such as Physician certification and re-certification.
• Perform concurrent MDS reviews to ensure appropriate RUGs categorization through the capture of clinical information.
• Participate in the interdisciplinary team to facilitate care plan development and management.
• Ensure timely completion of all MDS assessments (PPS, Unscheduled, Admission, Quarterly, Annual, Significant Change) in compliance with RAI guidelines.
• Collaborate with the interdisciplinary team to identify significant changes and implement Significant Change in Status MDS.
• Maintain an accurate schedule of all MDS assessments with proper reference dates.
• Track and rectify default days; implement corrective actions to prevent recurrence.
• Perform modification/inactivation of assessments per CMS policies in coordination with Regional Care Management Specialist.
• Audit the MDS process, validate coding documentation, evaluate outcomes, and utilize Data Integrity Audit reports per policy.
• Ensure timely electronic submission of all Minimum Data Sets and arrange back-up support as needed.
• Review validation and late/missed assessment reports monthly and take appropriate follow-up actions.
• Review QM and SNF QRP reports monthly and follow up as needed.
• Communicate with the Business Office Manager and Administrator on RUG distribution, default days/unassigned days, case mix index, and reimbursement impact.
• Participate in daily Case Management, weekly Level of Care, monthly Triple Check, and other RIHS policy meetings; assist with Additional Development Requests (ADRs), Reconsideration, and Administrative Law Judge (ALJ) processes.
• Serve as an RAI and Care Management resource to facility staff.
• Utilize AIS for annual competency training and as an educational resource as needed.
• Assist in orientation and training of new associates on the RAI process and disseminate updated RAI and regulatory materials.

Other Duties

• Manage day-to-day operations of the department and maintain knowledge of reimbursement regulations.
• Maintain organized data and effective communications with Regional Care Management Specialist regarding clinical reimbursement issues.
• Work flexible hours and utilize local and corporate resources as needed.
• Demonstrate superior clinical assessment and documentation skills and strong interpersonal abilities for teamwork.
• Perform other duties as assigned.

Key Competencies

• Analytical reasoning
• Logical reasoning
• Problem solving
• Time management
• Organizational skills
• Research skills
• Language skills
• Excellent verbal and written communication and presentation skills

Qualifications

Educational/Training Requirements

• Must be a graduate of an accredited school of nursing with current R.N. or L.V.N. licensure.
• ● Position may be filled by LVN, however specific job functions denoted by "" will require an RN to coordinate the process as stipulated by Federal Regulations.
• Complete and pass RIHS-specific MDS/RUGs training modules (AIS) within the first 90 days of employment and ongoing per policy.
• Competency with standard office software and MDS/RAI-related software.
• High initiative with ability to lead interdisciplinary teams and coordinate/manage the RAI process.

Licensing Requirements

• Licensure in the state of employment.

Experience Requirements

• Minimum of two years health care experience.
• Experience with MDS completion, reimbursement, clinical resource utilization and/or case management is desirable.

Physical Demands

The following physical demands are representative but not inclusive. The role requires regular communication and the ability to perform essential functions. Reasonable accommodations may be made for individuals with disabilities.

• Lifting, carrying, pushing/pulling, and sliding/transferring across various weight categories (as applicable).
• Standing, walking, reaching, and complex movements as needed for patient care.
• Driving as part of job duties.

Regency Integrated Health Services is an Equal Opportunity Employer. Regency does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, disability status, national origin, veteran status, or any other basis covered by law. All employment decisions are based on legitimate, non-discriminatory criteria.