MINIMUM DATA SET (MDS) COORDINATOR – CMM payroll code

Avir Vista; Pharr (TX); On-site; USD 65,000 - 85,000; Full time

Job summary

Apploi is seeking an RN to manage the RAI process from resident admission through discharge. You will ensure MDS accuracy, develop tailored care plans, and coordinate assessments with multiple clinical departments.

You will lead daily PPS/OBRA case management meetings and support QA initiatives to optimize funding and compliance. The role requires strong nursing practice, knowledge of RAI, PPS, and Texas Case Mix, plus excellent communication and teaching skills for both individual and group

Qualifications

• Must be a Registered Nurse (RN) in good standing and licensed by the State.
• Completion of post secondary education or able to read, write and follow directions.
• Must relate positively to residents and families and work cooperatively.
• Must be capable of maintaining regular attendance.
• Prefer two years in long term care with Medicare/Case Management/Medicaid.
• Must have knowledge of RAI Process, PPS requirements, Texas Case Mix, reimbursement forms and documentation.
• Must have computer skills and proficiency.
• Must have excellent communications and teaching skills in both individual and group settings.
• Capable of performing Essential Job Functions with/without reasonable accommodation

Responsibilities

• Manage the RAI Process from admission to discharge to maintain clinical compliance and funding.
• Oversee MDS completion in a timely, accurate, documented manner; develop individualized care plans; oversee data collection tool; coordinate assessments.
• Coordinate daily PPS/OBRA case management meetings and attend related staff meetings.
• Support clinical goals and maintain QA standards; promote residents’ quality of life.
• Ensure Residents’ rights are understood and promoted.
• Participate in staff development, orientation programs, and job skills training.
• Perform other duties as assigned.

Skills

RN

Communication skills

Teaching skills

Computer skills

Attention to detail

Education

RN license (Texas)

Tools

PPS software

EHR systems

Job description

Job Purpose:

To manage the RAI Process, adhering to Federal and State guidelines, and in accordance with company’s policies and procedures

Essential job Duties and Responsibilities:

Manage Area or Programs:

Manage the RAI Process from resident admission to discharge in order to maintain clinical compliance and receive funding from Medicare, Medicaid and Managed Care pay sources. Responsibilities include MDS completion in a timely, accurate, documentation-supported and case mix optimized manner; development of individualized care plans reflective of the residents’ status; oversight of the resident care data collection tool; coordination of assessments and services by other clinical departments; liaison to rehab team; audit and survey preparation, implementation and response; managed care clinical authorization and justifications; State-required form completion; activities of daily living (ADL) training and support; restorative nursing program management and other duties related to case mix management.

Meeting Management:

Responsible for managing the daily PPS/OBRA case management meetings; restorative/rehabilitation and level of care meetings. Attends daily start up, stand up, stand down and weekly standards of care meetings in order to identify resident changes that impact the MDS and/or Care Plan. Participates in weekly standards of care meeting and monthly quality assurance and triple check meetings.

Clinical Support:

Supports the clinical goals of the facility and participates as a member of the nursing management team to maintain compliance with State, Federal and company Quality Assurance standards and optimize the residents’ quality of life.

Resident Rights:

Understand, comply with and promote all rules regarding Residents’ rights.

Other Job Functions:

Staff Development:

Participate in in-service training, assist in implementing orientation programs and job skills training, maintains professional competence

Other Duties:

Other duties as assigned

Physical and Sensory Requirements (with or without the aid of mechanical device):

Works in a climate-controlled and well-lighted environment.. Works in an office and throughout the building daily. Has Category 1 risk of exposure to infectious diseases, but receives training in handwashing practices and Universal Precautions and has access to personal protective equipment if direct exposure is anticipated. Is subject to interruptions, noise, and odors daily

Walking, reaching, climbing, bending, lifting, grasping, fine hand coordination, pushing and pulling, ability to distinguish smells, tastes and temperatures, ability to communicate with residents and employees, ability to understand and follow training, ability to instruct staff in service education, and the ability to remain calm under stress.

Qualifications:

Must be a Registered Nurse (RN) in good standing and currently licensed by the State.

Completion of post secondary education or other wise able to read, write and follow oral and written directions at a level necessary to accomplish the job.

Must be able to relate positively and favorably to residents and families and to work cooperatively with other associates.

Must be capable of maintaining regular attendance.

Prefer two years experience in long term care with a good working knowledge of Medicare/Case Management/Medicaid.

Must have knowledge of RAI Process, PPS requirements, Texas Case Mix, reimbursement forms and the necessary documentation.

Must have computer skills and proficiency.

Must have excellent communications and teaching skills in both individual and group settings.

Must be capable of performing the Essential Job Functions of this job, with or without reasonable accommodation

“At Will” Statement:

This job description provides guidelines only and none of its provisions are contractual in nature. The Job Description does not guarantee employment for any specific period of time or any specific terms or benefits of employment. All employment with the Company is “at will,” meaning that you or the Company may terminate the employment relationship at any time, with or without notice or cause. No member of the Company’s management staff has the authority to make oral or written promises of employment that are inconsistent with the policy of at-will employment. The at-will nature of employment may only be modified through a written employment agreement signed by the head of the Company’s governing body and the team member.

Health Insurance Portability and Accountability Act (HIPAA):

Our Facility is committed to protecting the privacy, security and integrity of individually identifiable health information received from or on behalf of our employees. The Facility adheres to the highest standards of integrity in the performance of its business and is prepared to maintain compliance with HIPPA and other regulatory requirements by adopting and adjusting policies and processes as necessary. All employees are required to adhere to all HIPPA regulations