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Case Mix/Mds Coordinator

Company

Med Center Health
Address , Scottsville, 42164, Ky
Employment type PART_TIME
Salary
Expires 2023-10-03
Posted at 9 months ago
Job Description
  • Currently licensure in the Commonwealth of Kentucky as a Registered Nurse required.
  • May conduct regularly scheduled in-services to communicate changes in the MDS or Care Plan process, documentation guidelines.
  • Plans and facilitates the interdisciplinary care plan meetings. Collaborates with Social Services Director to include resident, family and other staff in the care planning process. Ensures that care plans are initiated and revised as necessary to reflect the resident needs.
  • Participates in Performance Improvement team, rehab meetings, and other committees as required.
  • Job Specific Performance Standards
      The duties listed below are a summary of the major essential functions of this position. The position may require other duties, both major and minor, that are not mentioned, and specific functions may change from time to time.
      • Assists with pre-admission screening of potential admissions for appropriateness and necessary medical information to meet SNF or IC levels of care. Attends daily admissions/UR meetings.
      • Communicates with interdisciplinary care plan team and coordinates the schedule of assessments and care plans for residents.
      • Completes the Minimum Data Sets (MDS), RAP summaries, care plans, etc. and reviews for accuracy and completeness by the other disciplines within the mandated time frames as required by regulatory standards. Ensures that required signatures and hard copy of the MDS are filed on the medical record. Signs off as the RN Coordinator.
      • Encodes and transmits required resident data and MDS information to state agencies with specified time frames.
      • Plans and facilitates the interdisciplinary care plan meetings. Collaborates with Social Services Director to include resident, family and other staff in the care planning process. Ensures that care plans are initiated and revised as necessary to reflect the resident needs.
      • Obtains certification numbers for Medicaid and calls in ancillary services as mandated.
      • Collaborates with the Director of Nursing to monitor medical records for appropriate documentation. Ensures that pertinent and/or required information is maintained in the medical record for Case Mix reimbursement and other payor sources.
      • Functions as the primary contacts for the HealthCare Review nurse to facilitate the case mix review process. Prepares list of residents on quarterly target date for case mix review. Assists Health Care Review Nurses as necessary.
      • Participates in Performance Improvement team, rehab meetings, and other committees as required.
      • Reviews applicable JCAHO standards and other regulatory standards to ensure standards are being met.
      • Prepares reports and addresses inquiries requested by Administration.
      • May conduct regularly scheduled in-services to communicate changes in the MDS or Care Plan process, documentation guidelines.
  • Communicates with interdisciplinary care plan team and coordinates the schedule of assessments and care plans for residents.
  • Graduate from an accredited school of nursing required. Bachelor’s degree in nursing or related field preferred.
  • Three years of Registered Nurse long term care experience or related field. Experience with long term care regulations. Basic knowledge Medicare/Medicaid reimbursement in long term care. Experience with LTC Electronic Medical Records preferred.
  • Functions as the primary contacts for the HealthCare Review nurse to facilitate the case mix review process. Prepares list of residents on quarterly target date for case mix review. Assists Health Care Review Nurses as necessary.
  • Assists with pre-admission screening of potential admissions for appropriateness and necessary medical information to meet SNF or IC levels of care. Attends daily admissions/UR meetings.
  • Position Summary
      Facilitates and coordinates the Resident Assessment Instrument (RAI) process, including prescreening admission, scheduling and completing assessments. RAP’s (Resident Assessment Protocols), interdisciplinary care plans and other assessments as mandated by regulatory standards. Is responsible for planning, scheduling, facilitating, and ensuring the accuracy, completeness, and appropriateness of the interdisciplinary care plan process. Reviews and monitors medical record documentation for appropriateness and accuracy to meet requirements for Medicare/Medicaid reimbursement. Ensures proper case mix management. Responsible for the transmission of MDS date to HCFA. Assists the Administrator with projects and other duties as directed. Provides a supervisory role to all subordinate staff of long term care.
  • Completes the Minimum Data Sets (MDS), RAP summaries, care plans, etc. and reviews for accuracy and completeness by the other disciplines within the mandated time frames as required by regulatory standards. Ensures that required signatures and hard copy of the MDS are filed on the medical record. Signs off as the RN Coordinator.
  • Encodes and transmits required resident data and MDS information to state agencies with specified time frames.
  • Reviews applicable JCAHO standards and other regulatory standards to ensure standards are being met.
  • Prepares reports and addresses inquiries requested by Administration.
  • Collaborates with the Director of Nursing to monitor medical records for appropriate documentation. Ensures that pertinent and/or required information is maintained in the medical record for Case Mix reimbursement and other payor sources.
  • Obtains certification numbers for Medicaid and calls in ancillary services as mandated.
  • Minimum Qualifications
      Work Experience
      • Three years of Registered Nurse long term care experience or related field. Experience with long term care regulations. Basic knowledge Medicare/Medicaid reimbursement in long term care. Experience with LTC Electronic Medical Records preferred.

      Education
      • Graduate from an accredited school of nursing required. Bachelor’s degree in nursing or related field preferred.

      Certifications/Licensure
      • Currently licensure in the Commonwealth of Kentucky as a Registered Nurse required.

Location: Med Center Health · MCS Long Term Care
Schedule: Part Time, Day Shift