MDS RN

JOB SUMMARY :

The MDS RN coordinates Medicare, Managed Care and Medicaid activities at the facility. Educates Administrator

and facility staff on innovative procedures to maximize utilization and reimbursement through the completion of

the MDS, care plan and care guide process. Supervises LPN MDS work and cosigns any MDS completed by an

LPN.

RESPONSIBILITIES :

• Provides education and assistance to facilities on Medicare / Medicaid related areas including eligibility,

certification, coverage, documentation, utilization and reimbursement. Assists facilities with initial

certification procedures and follow-up of problem areas.

facility in complying with company procedures and federal, state and local regulations. Reports regularly

to administration on issues and activities. Interacts with the Medicare and managed Care intermediares

in areas of coverage and documentation. Assists in review and preparation of denied claims or

administrative record reviews by outside intermediaries.

company procedures. Establishes systems and programs designed to correct any non-compliance

situation. Participates with any outside reimbursement audits to acquire first-hand knowledge of areas

that might lead to system failures.

Medicaid programs by region. Cooperates with operations to monitor activities for contractor programs,

i.e. therapies, utilization review. Reviews and maintains Medicare, Managed Care and Medicaid

reference materials.

reimbursement. Monitors compliance with third party policies and procedures for authorizations for

payment and provision of services.

Care and Medicaid and other contracted third party payers. Provides education regarding changes in any

reimbursement program.

admissions and re-admissions

REQUIRED SKILLS & ABILITIES :

MDS assessment

improvement

QUALIFICATIONS :

Education : Minimum : Associates degree in Nursing

Preferred : Bachelor's degree in Nursing

Experience : Minimum : 2 years of Long-Term Care Experience

Preferred : 4 years of long-term care experience

Licensure : NYS Licensed Registered Nurse (RN) current, unrestricted licensure

Certification : RAC-CT certification preferred

Benefits :

Apply today to be part of a team committed to delivering excellent care while supporting operational excellence in a friendly and collaborative environment

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)