MDS Director

Volare Health, LLC•Grants Pass, OR

11h

About The Position

Highland House is seeking an experienced RN to join our team as the MDS Director! Volare Health portfolio of long-term care skilled nursing and short-term rehabilitation centers located in multiple states. We welcome our residents, their families, and our staff with warm hearts. While you make a difference in the daily lives of our residents, we support you with leading market wages and help guide you along your career path.

Requirements

Must have a current, active Registered Nurse (RN) License in State of practice.
Must be well-versed in inter-personal communications.
Must be familiar with the RAI process and Case Management.

Responsibilities

Works in collaboration with the interdisciplinary team to assess the needs of the residents.
Participates in the pre-admission process to ensure essential information needed for MDS optimization is obtained from the referral source(s).
Assists in the review of resident care and the setting of the ARD to ensure the most appropriate ARD is utilized for Prospective Payment System MDS Assessments.
Ensures accurate and timely completion of resident assessments according to state and federal regulations.
Completes accurate coding of the MDS with information obtained from interviews with facility staff, residents and family members, as well as observation of the resident and medical record review.
Maintains the MDS schedules.
Obtains, reviews, and maintains State and Federal reports making appropriate corrections.
Completes required forms and documents in accordance with company guidelines and state and federal regulations.
Participates in quality assurance activities.
Monitors nursing documentation for daily skilled services, medical necessity, rehabilitation progress. and ADL function for MDS coding accuracy.
Collaborates with DON/DNS to provide education related to MDS/Care Management processes for the facility.
Reviews MDS validation reports to identify issues and/or processes to ensure accuracy of submitted MDS.
Tracks and reviews all claim denials to identify problems, and implements processes to prevent future denials.
Identify clinical reimbursement issues.
Reviews quarterly State CM resident rosters for accuracy. Corrects any inaccuracies in a timely manner.
Participates in the coordination and timely completion of Medicare Part A and Part B certification/recertification.
Reviews medical records, care plans, charting to monitor that documentation supports care provided and meets the skilled coverage requirements for reimbursement.
Monitors facility practice to ensure compliance with guidelines for participation in Medicare, Medicaid, and other benefit programs. Initiates action needed to ensure compliance.
Participates in the triple check process prior to releasing claims.
Other duties and responsibilities as assigned or need.