Regional MDS/RAI Consultant — Nurse Leader

SanStone Health & Rehabilitation; Greensboro (NC); On-site; USD 90,000 - 120,000; Full time

Job summary

SanStone Health & Rehabilitation seeks an experienced RN- Regional Consultant to support the MDS/RAI process across the region, providing education and guidance to facilities to ensure compliant, accurate PDPM and Case Mix data for appropriate reimbursement.

The role requires current RN licensure, a bachelor’s or associate degree in nursing, and a minimum of 3 years’ RAI experience. Travel and strong communication are essential for success in this regional role.

Qualifications

• Current license as a Registered Nurse.
• Bachelor’s degree or Associate degree in nursing from accredited college.
• Minimum 3+ years experience with the RAI process.
• Strong Knowledge of PDPM and State Case Mix Time weighted Reimbursement payment system.
• Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.
• Effective verbal and written English communication skills.

Responsibilities

• Provides leadership, oversight and acts as a resource for regional and facility staff specific to the RAI process, the Medicare program, and Medicaid Case Mix as applicable.
• Conducts regular monitoring of facility Medicare management and Case-Mix.
• Works with Regional Nurse Consultant to provide education and support for QM and CMS Five Star Rating.
• Supports accurate claims and billing.
• Leads and participates in program improvement and development efforts related to the RAI, Medicare and Medicaid programs.
• Conducts follow-up evaluations to validate systems are functioning well after rollout.
• Participates in the Quality Assurance Process Improvement Program and root cause analysis.

Skills

RN licensed

RAI/MDS expert

PDPM knowledge

Communication skills

Team collaboration

Travel ability

Education

Bachelor’s or Associate degree in Nursing

Job description

SanStone Health & Rehabilitation seeks an experienced RN- Regional Consultant to support the MDS/RAI process across the region, providing education and guidance to facilities to ensure compliant, accurate PDPM and Case Mix data for appropriate reimbursement.

The role requires current RN licensure, a bachelor’s or associate degree in nursing, and a minimum of 3 years’ RAI experience. Travel and strong communication are essential for success in this regional role.