MDS Manager Short-Term Rehabilitation

Salary Range: $85,000-$105,000 Exempt (Pay information will vary depending upon relevant experience for the position)
Full Time 40 hours Days Monday-Friday

GENERAL SCOPE:  The MDS Manager for Short-Term Rehab plays a critical role in overseeing reimbursement processes for skilled nursing services, ensuring compliance with state and federal regulations. Managing a team of MDS Specialists, this position requires a strong clinical background, expertise in Medicare, Medicaid, Managed Care, and PDPM reimbursement methodologies, excellent analytical skills and effective communication skills.

EDUCATION / QUALIFICATION: Current NYS Registered Nurse (RN) License.   Resident Assessment Coordinator-Certification (RAC-CT) preferred.   Working knowledge in PDPM, MDS, ICD-10 coding, Medicare/Medicaid/Managed Care reimbursement. Strong analytical skills, attention to detail, and ability to interpret complex regulations.

ESSENTIAL FUNCTIONS:

• Oversight and supervision of MDS Specialists that results in a high functioning team.
• Evaluate and determine Medicare and continued Medicare coverage for both new and readmitted residents, utilizing current criteria and protocol. Monitors residents for skilled level of care.
• Completes MDS assessments according to RAI guidelines assuring the availability of supporting documentation that will accurately capture acuity both from internal and external sources.
• Work closely with the rehab clinical team to ensure assessments scheduled maximize acuity.
• Assist with triple check process to ensure clean claims.
• Regularly audit for compliance with Medicare regulations and MDS accuracy.
• Possess working knowledge of all QMs, QRP, and VBP.
• Coordinates and communicates pertinent information to appropriate departments to maximize reimbursement and to ensure regulatory compliance.
• Serve as a resource for staff in all aspects of skilled services eligibility guidelines, reimbursement maximization, and accuracy of MDS 3.0 completion.
• Coordinate other clinically required documentation for skilled services i.e. physician certifications, beneficiary notices, etc.
• Stays abreast of changes/clarifications re: MDS 3.0, PDPM and maintains RAC-CT certification.
• Assists in training JHR’s employees regarding reimbursement system and MDS completion.
• Member of the Quality Assurance Performance Improvement (QAPI) Committee
• All other job duties as assigned.

This description is not meant to be an all-inclusive list of duties and responsibilities, but constitutes a general definition of position scope.

Jewish Home is committed to equal employment opportunity. We will not discriminate against employees or applicants for employment on any legally-recognized basis [“protected class”] including, but not limited to: veteran status, uniform service member status, race, color, religion, sex, sexual identity, gender identity or expression, national origin, age, physical or mental disability, genetic information or any other protected class under federal, state, or local law.

Salary : $85,000 - $105,000