RAI Specialist for Skilled Nursing Services

CHSGa•Gray, GA

20h•Hybrid

About The Position

Provides consultant support to skilled nursing center associates that ensures the accuracy of clinical assessments to reflect actual acuity levels of patients. Provides education, audit functions and resources that contribute to a strong interdisciplinary process.

Requirements

Five (5) years MDS/RAI experience
One (1) year management or supervisory experience
RN licensure in Georgia or compact state
RAC-CT Certification within 6 months and maintain re-certification every 2 years.
Knowledgeable of nursing and medical practices as well laws, regulations and guidelines that pertain to long-term care.
Knowledge and experience in MDS/RAI process, Quality Measures, and Medicaid Case mix
Strong communication, collaborative and leadership skills
Valid driver’s license.
Must be able to travel frequently across Georgia and work irregular hours.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customers or associates of the organization.
Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram format.
The ability to deal with problems involving several concrete variables in standardized situations.
Proficiency with Microsoft Outlook, Microsoft Excel, Microsoft Word.

Responsibilities

Conducts 100% review of Medicare MDS’ for assigned nursing centers utilizing clinical software and reports at a minimum on a monthly basis.
Responsible to oversee assigned centers are completing timely transmission of assessment information through review and communication with skilled nursing center.
Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures.
Provides leadership, support, as well as education to skilled nursing center associates throughout the system regarding RAI and Nursing related processes.
Develops, designs, and conducts training related to the RAI process. Conducts on site, center visits to provide training and education as well as offsite trainings.
Completes center visits and conducts reviews/audits/ to assess compliance and adherence to federal as well as state regulatory standards within the RAI process.
Provides ongoing training of computer software related to the RAI process, Minimum Date Set (MDS), Resource Utilization Groups (RUGs), Quality Measures (QMs), and care plans
Conducts initial and ongoing training to provide for competency of skills for RAI Directors /RAI coordinators within the system with continued monitoring and oversight to ensure proficiency.
Disseminates information related to MDS/RAI/Case Mix/PPS/QM to others in organization.
Visits nursing centers as needed for initial on-boarding / orientation support of RAI associates.
Participates in corporate staff meetings as appropriate.
Makes written and oral reports/recommendations to skilled nursing center Administrator, Division Vice President for Skilled Nursing Services and Director of Clinical Assessment for Skilled Nursing Services as necessary/required, concerning skilled nursing center operations related to MDS/RAI and Resource Utilization.
Completes knowledge of the MDS/RAI process, QMs and case mix classifications system for long term care, known as RUGs.
Designs and presents educational programs to meet specific training needs in the areas of MDS/RAI process, QM’s, and case mix systems including the Prospective Payment System and Medicaid Case Mix/Utilization Review processes.
Makes recommendations to skilled nursing center Administrator, Division Vice President for Skilled Nursing Services and Director of Clinical Assessment for Skilled Nursing Services related to skilled nursing center staffing needs, which relate to MDS/RAI.
Provides input to skilled nursing center Administrator/ Division Vice President for Skilled Nursing Services regarding personnel in the skilled nursing centers.
Participates in appropriate committees, as directed by the Director of Clinical Assessment for Skilled Nursing Services
Participates in Georgia Nursing Home Association Committees/activities as appropriate and approved.
Attends and participates in workshops, seminars, etc., to stay abreast of current changes in the field of expertise, as well as to maintain a professional status.
Attends and participates in mandatory in-service training.
Communicates well with other associates, patients, family members, and visitors providing warm and friendly greeting and an approachable attitude. Responds to expressed concerns while displaying a helpful, caring demeanor, answers questions when appropriate in a professional manner.
Honors patients’ rights to fair and equitable treatment, self-determination, individuality, privacy, property and civil rights, and respect.
Follows established safety regulations when performing job tasks to include fire protection/prevention, infection prevention, and occupational hazards. Report any exposures as required.
Complies with the organization’s Compliance, Privacy and Security programs.
Promotes the image and reputation of the System by exhibiting servant leadership and providing direct and open lines of communication.
Contributes to the work of committees, workgroups, project management, and other collaborative efforts of the System.
Performs other duties as necessary to ensure the success of the System.