RN - MDS Coordinator

Elderwood•West Roxbury, MA

6d•Onsite

About The Position

The RN – MDS Coordinator plays an essential role in connecting clinical assessment with quality resident care at West Roxbury Health & Rehabilitation Center, a 76-bed skilled nursing and rehabilitation community. This role involves using clinical expertise to shape individualized care plans, ensuring accurate assessments, and maintaining alignment with Medicare, Medicaid, Managed Care, and regulatory requirements. The position offers an opportunity for an experienced RN to utilize their clinical judgment, organization, communication, critical thinking, and attention to detail beyond the traditional bedside setting, while remaining closely connected to resident care. The work directly impacts resident outcomes by identifying and responding to changing needs, developing meaningful care plans, coordinating services, supporting positive clinical outcomes, and ensuring accurate reimbursement processes.

Requirements

Current Registered Nurse (RN) license in the state of Massachusetts.
Nursing degree from an accredited college or university.
Knowledge of the MDS and care planning process.
Strong understanding of resident assessment, care planning, and regulatory requirements.
Excellent verbal and written communication skills.
Strong organizational and time-management skills with the ability to manage multiple deadlines.
Self-motivated, detail-oriented, and committed to accuracy.
Ability to collaborate effectively with residents, families, nursing staff, interdisciplinary team members, leadership, and external partners.
Ability to read, write, speak, and understand the English language at an intermediate or more advanced level.

Nice To Haves

Previous experience in a skilled nursing or long-term care environment preferred.
Prior experience with MDS 3.0 scheduling, coding, and submission requirements preferred.
Experience with PointClickCare preferred.
Knowledge of Patient Driven Payment Model (PDPM) and Case Mix Index (CMI) preferred.
Experience with Medicare/PPS, Medicaid, Managed Care, Part A coverage, and reimbursement processes preferred.
A willingness to learn and develop — we're open to training the right candidate with strong clinical experience and the ability to grow into the MDS role.

Responsibilities

Lead the MDS & Resident Assessment Process: Complete and/or oversee completion of MDS/PPS and OBRA assessments for residents receiving short-term rehabilitation and long-term care. Establish and maintain schedules for required assessments in accordance with federal and state regulations. Ensure MDS assessments, supporting documentation, and related components are accurate, complete, and submitted within required timeframes. Monitor completion of MDS components by other disciplines and address incomplete or untimely information. Review resident records, incidents, accidents, 24-hour reports, and changes in condition to ensure assessments and care plans accurately reflect current needs. Utilize clinical judgment and attention to detail to identify relevant changes in resident status.
Develop & Coordinate Individualized Care Plans: Initiate, maintain, and update individualized care plans based on resident assessments and changing clinical needs. Ensure care plans identify appropriate interventions and supporting activities designed to achieve the best possible resident outcomes. Conduct care plan conferences with residents, families, and members of the interdisciplinary team. Generate and distribute the monthly care plan calendar. Collaborate closely with nursing, rehabilitation, social services, dietary, medical records, and medical providers. Serve as a clinical resource to members of the care team regarding assessment and care planning requirements.
Support Medicare, Medicaid & Reimbursement: Complete and/or oversee Medicare PPS assessments for both short-term and long-term care residents. Support accurate documentation related to Medicare, Medicaid, Managed Care, and other reimbursement requirements. Partner with the Business Office to support Medicare eligibility determination and tracking of covered days. Serve as a facility contact and liaison with Managed Care providers regarding authorization and reimbursement. Apply knowledge of PDPM, Case Mix, Medicare/PPS, and reimbursement methodology to support accurate and compliant processes. Collaborate with Medical Records and Therapy staff in preparing documentation for CMS and other entities for pre- and post-payment reviews, ADR requests, and appeals.
Promote Compliance, Quality & Accountability: Maintain working knowledge of applicable federal and state regulations related to MDS, care planning, Medicare, Medicaid, and resident care. Help ensure documentation and assessment practices remain compliant with regulatory requirements. Identify gaps or delays in the assessment process and communicate concerns to nursing leadership. Support survey readiness and respond appropriately to documentation and assessment-related requests. Maintain knowledge of facility policies, procedures, corporate compliance standards, and professional nursing expectations. Participate in ongoing quality improvement initiatives and other projects as assigned.