Role OverviewCoordinates training of center partners and audits, providing recommendations for Process Improvement for the RAI Process, Care Management Process, and supporting software applications to ensure appropriate resident care and equitable reimbursement. This role involves utilization of skilled Medicare services and Medicare RUG, Medicaid Case Mix CMI, or Skilled Level of Care management.
What You Will Do
Distributes RAI/PPS/Case Mix information to partners, provides information to regional and corporate staff on clinical and financial reimbursement, participates in professional organizations, and provides education on RAI and Care Plan processes. Also provides expertise to ensure MDS accuracy, identifies trends for improvement, maintains knowledge of clinical software, interviews applicants for Case Mix Director/MDS Nurse, and oversees orientation for new CMDs.
Why It Might Be a Fit
Requires five years of health care management experience with MDS Assessment and care planning in multi-facility long-term care organizations, and three years of clinical responsibility with RAI process. Candidates should have knowledge of state and federal regulations, be a current Licensed Registered Nurse or Allied Health Care Professional, and have experience with Microsoft, MatrixCare, and Pointright.
Requirements
- Current Licensed Registered Nurse or Allied Health Care Professional in state of residence
- Bachelors’ degree from an accredited school of Nursing or other Allied Health Care Institution
- Five (5) years health care management, MDS Assessment & care Planning experience in multi-facility, long-term care organizations preferred
- Three (3) years clinical responsibility and experience with RAI process (MDS) required
- Current, active license as a Registered Nurse or Allied Health Professional in the State practicing
- Knowledge of state and federal regulations, both clinical and financial as it relates to the RAI process and reimbursement systems
- Microsoft required
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