MDS Lead RN

LivingLegendsHealth; Town of Cheektowaga (NY); On-site; USD 75,000 - 77,000; Full time

Benefits offered by this job

Paid Time Off

Weekly or Same-Day Pay Options

Health, Dental, and Vision Insurance

Life Insurance

Employee Referral Bonus Program

Job summary

Garden Gate Health Care Facility in Cheektowaga, NY is seeking an MDS Lead RN to coordinate Medicare, PDPM and Medicaid reimbursement while ensuring accurate MDS completion and regulatory compliance. You will oversee MDS processes, audits and staff education, contributing to reimbursement optimization and high-quality resident care.

The role requires NYS RN licensure, 2+ years in long-term care with MDS/PDPM experience, and strong leadership and communication skills.

Qualifications

• RN licensure in NYS (unrestricted)
• MDS/PDPM reimbursement experience in long-term care
• Knowledge of Medicare/Medicaid/Managed Care requirements
• Strong time management and organizational skills
• Leadership ability to mentor and support team members
• Ability to educate interdisciplinary teams

Responsibilities

• Educate facility staff on Medicare/Medicaid policies, eligibility and documentation
• Coordinate MDS processes, audits, and reimbursement optimization
• Review denials and prepare administrative records for audits
• Monitor PDPM reviews at admission and re-admission
• Ensure regulatory compliance and action plans for payer requirements
• Supervise MDS LPN activities and co-sign MDS assessments
• Gather documentation for CMS audits and ICD-10 coding accuracy
• Support claims review units and third-party payers
• Provide ongoing reimbursement education and training

Skills

MDS Lead RN leadership

PDPM knowledge

Medicare/Medicaid reimbursement

Regulatory compliance

Strong communication

Team mentorship

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing preferred

Job description

• Pay or shift range: $74,880 USD to $76,960 USD
  The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, shift, benefit selection or other job-related reasons.

Description

MDS Lead RN
Salaried: $74,880 - $76,960, exempt (depending on experience)
Equivalent to $36 - $37/hour
Shift: Full-Time, Days

Garden Gate Health Care Facility is looking to add an MDS Lead RN to its team. In this role, you’ll coordinate Medicare, Managed Care, and Medicaid reimbursement activities while ensuring accurate MDS completion, regulatory compliance, and reimbursement optimization. You’ll also provide education and support to facility staff while overseeing MDS processes and assisting with reimbursement-related audits and reviews. If you have experience with MDS, PDPM, and long-term care reimbursement, this could be the perfect opportunity for you.

Located in Cheektowaga, NY, Garden Gate Health Care Facility is proud to be part of The McGuire Group, a recognized leader in skilled nursing, rehabilitation, and long-term care services throughout New York State. Our team is dedicated to creating a welcoming environment where residents, families, and employees feel valued and supported. With a strong focus on compassion, teamwork, and resident-centered care, Garden Gate offers a rewarding opportunity to grow your career while making a meaningful difference in the lives of others every day.

RESPONSIBILITIES:

• Provide education and support to facility staff regarding Medicare, Medicaid, Managed Care, eligibility, certification, coverage, documentation, utilization, and reimbursement
• Assist facilities with certification procedures, reimbursement-related processes, and resolution of problem areas
• Collaborate with claims review units, compliance teams, and third-party payers to ensure regulatory and company compliance
• Assist with the review and preparation of denied claims, audits, and administrative record reviews
• Assess compliance with Medicare, Medicaid, Managed Care, and third-party payer requirements and develop corrective action plans as needed
• Maintain and analyze reimbursement-related statistical data and utilization trends
• Monitor authorizations and compliance with third-party payer requirements
• Provide ongoing education and training related to reimbursement programs and regulatory changes
• Conduct PDPM reviews upon admission, re-admission, or as indicated
• Review Medicare Part A MDS assessments for accuracy and compliance
• Supervise MDS LPN activities and co-sign MDS assessments completed by LPN staff as required
• Gather documentation for CMS audits and other reimbursement-related audits
• Review physician documentation and assist with accurate ICD-10 coding and diagnosis ranking
• Conduct MDS integrity reviews and complete MDS assessments as needed
• Perform additional duties as assigned

REQUIREMENTS:

• Minimum education requirement: Associate's Degree in Nursing; Bachelor's Degree in Nursing preferred
• Minimum experience requirement: 2 years of long-term care experience; 4 years of long-term care experience preferred
• Current unrestricted NYS Registered Nurse (RN) License required
• Experience with MDS, PDPM, reimbursement, and quality measures
• Strong understanding of Medicare, Medicaid, Managed Care, and third-party payer requirements
• Excellent time management, organizational, and problem-solving skills
• Proven leadership skills with the ability to mentor and support team members
• Strong communication and interpersonal abilities
• Ability to manage multiple priorities and meet deadlines
• In-depth knowledge of long-term care regulations, reimbursement methodologies, and standards of care
• Ability to provide education, training, and support to interdisciplinary teams

BENEFITS:

• Paid Time Off (PTO) for Full-Time and Part-Time
• Weekly or Same-Day Pay Options
• Health, Dental, and Vision Insurance
• Life Insurance
• Employee Referral Bonus Program

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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