RN MDS/RAI Coordinator - Compliance & Care Planning

Avir at Commons; Athens (TX); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health insurance

Job summary

Avir at Commons in Texas is seeking a Registered Nurse to manage the RAI process and oversee PPS/OBRA-related activities to ensure clinical compliance and funding support from Medicare, Medicaid and managed care.

The role requires strong knowledge of RAI, PPS requirements, Medicare/ Medicaid processes, and computer skills; you will lead a nursing management team, coordinate between departments, and promote residents' quality of life while maintaining regulatory standards.

Qualifications

• Must be a Registered Nurse (RN) in good standing and currently licensed by the State.
• Completion of post secondary education or otherwise 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

Responsibilities

• Manage the RAI Process from resident admission to discharge to maintain clinical compliance and funding from Medicare, Medicaid and Managed Care pay sources.
• Development of individualized care plans reflective of 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; clinical authorization and justifications; state-required form completion.
• ADL training and support; restorative nursing program management and other duties related to case mix management.
• Manage the daily PPS/OBRA case management meetings; participate in weekly and monthly standards of care meetings.
• Support the clinical goals of the facility and participate as a member of the nursing management team to maintain compliance with QA standards.
• Promote Residents’ rights and ensure adherence to all policies.
• Participate in in-service training and assist with orientation programs and job skills training.

Job description

Avir at Commons in Texas is seeking a Registered Nurse to manage the RAI process and oversee PPS/OBRA-related activities to ensure clinical compliance and funding support from Medicare, Medicaid and managed care.

The role requires strong knowledge of RAI, PPS requirements, Medicare/ Medicaid processes, and computer skills; you will lead a nursing management team, coordinate between departments, and promote residents' quality of life while maintaining regulatory standards.