RN Assessment Review Lead — Quality & Submissions

CareSource; Oklahoma City (OK); On-site; USD 72,000 - 116,000; Full time

Benefits offered by this job

Bonus tied to performance

Job summary

CareSource is seeking a Team Lead, Assessment Review & Submission to supervise a team of RN Reviewers responsible for quality assessments and timely submissions. The role requires RN licensure and experience with MDS processes.

The incumbent will train staff, monitor performance, and collaborate with senior management to optimize workflows and rating accuracy. This position emphasizes compliance and member-focused care.

Qualifications

• Associates degree in Nursing is required.
• Two years of experience completing MDS assessments.
• Two years with electronic medical records.
• Prior supervisory experience preferred.
• Experience developing documentation of processes preferred.

Responsibilities

• Lead and supervise RN Reviewers to ensure timely, compliant assessments and submissions.
• Onboard and train assessment review nurses on SOPs and quality standards.
• Maintain expert knowledge of MA assessment processes and rating categories.
• Balance nurse workload with manager to ensure on-time submissions and quality.
• Review assessment visits to develop best practices and improve patient experience.
• Collaborate to improve workflow and achieve team objectives.
• Identify potential downgrades or upgrades and review rating categories as needed.
• Analyze claims, medical records, and data to flag misclassified members and request status changes.

Skills

UCA assessment tool

Oral and written communication

Analytical skills

Organizational skills

Teaching skills

Microsoft Excel

Team collaboration

Communication of complex concepts

Education

Associate degree in Nursing

Bachelor's degree in Nursing

Tools

Electronic Health Records (EMR)

Job description

CareSource is seeking a Team Lead, Assessment Review & Submission to supervise a team of RN Reviewers responsible for quality assessments and timely submissions. The role requires RN licensure and experience with MDS processes.

The incumbent will train staff, monitor performance, and collaborate with senior management to optimize workflows and rating accuracy. This position emphasizes compliance and member-focused care.