RN Case Manager: MDS & PDPM Compliance Lead

SLP Operations; Llano (TX); On-site; USD 70,000 - 95,000; Full time

Job summary

SLP Operations is seeking a Clinical Case Manager (RN or LVN) to coordinate and certify RAI and MDS within regulatory guidelines for Medicare, Medicaid, and managed care residents. The CCM collaborates with an interdisciplinary team to ensure accurate assessments, individualized care planning, and proper reimbursement while maintaining quality and cost-effective resident care.

Responsibilities include managing the RAI from admission to discharge, submitting MDS assessments, reviewing analytics,

Qualifications

• Must be a licensed RN or LVN in good standing.
• Experience with Minimum Data Set (MDS) and care planning preferred.
• Proficiency with computer applications, including Microsoft Office and Outlook.

Responsibilities

• Coordinate and certify RAI and MDS in compliance with regulations.
• Manage RAI from admission to discharge to ensure reimbursement.
• Review MDS analytics and correct/re-submit assessments as needed.
• Perform daily rounds on Medicare Part A and Managed Care residents.
• Assign ICD-10-CM codes to support skilled services.
• Coordinate physician certification and re-certification for residents.
• Collaborate with IDT and Business Office for care planning and authorizations.
• Attend PPS, care plan, quality, and reimbursement meetings.
• Ensure NOMNCs and PASRR compliance as required.
• Provide training to nursing staff on ADLs and case management responsibilities.

Skills

RN/LVN licensed

Team collaboration

MDS experience

MS Office/Outlook

Geriatric care

Education

RN or LVN license

Tools

Microsoft Office

Outlook

Job description

SLP Operations is seeking a Clinical Case Manager (RN or LVN) to coordinate and certify RAI and MDS within regulatory guidelines for Medicare, Medicaid, and managed care residents. The CCM collaborates with an interdisciplinary team to ensure accurate assessments, individualized care planning, and proper reimbursement while maintaining quality and cost-effective resident care.

Responsibilities include managing the RAI from admission to discharge, submitting MDS assessments, reviewing analytics,