POSITION SUMMARY

The Care Management Nurse works the RAI process and conducts assessments and care plan

coordination for those residents assigned.

QUALIFICATIONS

Education and/or Experience:

• Knowledge of the Resident Assessment Instrument (RAI) process, including the principles the

Prospective Payment Process (PPS) strongly preferred.

• Knowledge of regulatory standards and compliance requirements.

• Working knowledge of personal computer and software applications used in job functions, (word

processing, graphics, databases, spreadsheets, etc.)

• Strong organizational and analytical skills; oral and written communication skills.

• Demonstrated ability in independent functioning and strong leadership.

Certificates, Licenses, Registrations:

• Registered Nurse with a valid license preferred. If no Registered Nurse available, an LPN with

one year experience and excellent assessment skills is acceptable.

Minimum Qualifications:

• Knowledge of regulatory standards and compliance requirements.

• Working knowledge of computer.

• Strong organizational and analytical skills; oral and written communication skills.

• Working knowledge and ability to apply professional standards of practice in job situations.

• Freedom from use of and effects of drugs and alcohol in the workplace.

• Meets state and federal criminal background check requirements.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform each key function satisfactorily.

Reasonable accommodations may be made to enable individuals with disabilities to perform the key

functions.

• Coordinates scheduling the RAI process with the interdisciplinary team.

• Completes the MDS, CAA’s and care plans within regulated time frames.

o Assesses resident through physical assessment, interview and chart review.

o Interviews and discusses resident care needs with responsible party.

o Discusses resident care needs with care givers, including physician, nursing, social

services, therapy, dietary, and activity staff.

o Reviews information from hospital, consults and outside agencies and uses such

information in the completion of the assessment and care planning.

• Monitors interdisciplinary team to assure timely completion of the MDS that they are

responsible.

• Communicates with the interdisciplinary team new resident care needs.

• Coordinates, identifies, and/or initiates significant change MDS’

• Conducts a thorough resident assessment during quarterly reviews by interviewing the resident,

staff, and family.

• Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and

maintain PPS board for monitoring of Medicare days and RUGs utilization in the absence of the

Care Management Coordinator.

• Participates in direct and indirect Resident care activities as directed by supervisor. (This may

include duties listed in the Charge Nurse Job Description)

• In conjunction with the Social Worker, coordinates Resident Care Conferences to assure

residents and/or responsible parties participate in resident care planning for the assigned resident.

• Ensures that the quality and appropriateness of Resident care meets or exceeds company and

industry standards and ensures that all nursing services are in compliance with state and federal

legal, regulatory, accreditation and reimbursement guidelines.

• Attends and participates in departmental/facility meetings, as required.

• Demonstrates flexibility in adjusting to change, Resident needs and customer expectations; meets

company standards relating to deadlines and attendance.

• Establishes and maintains exemplary standards; ensures compliance with company and facility

policies and procedures.

• Adheres to all safety and risk management protocols and programs.

• Participates in quality improvement activities, which improve quality of care and services

through improved systems and processes as directed.

• Exhibits courtesy, compassion and respect to residents, families, visitors, physicians,

administrators and coworkers.

• Takes call as assigned.

• Performs other duties or functions as directed.