MDS Care Coordinator/Manager/RN -09-0150FT
|Employment Type:||Part Time|
|Description:||Summary: Responsible for all MDS's including the initial admission, quarterly, change of condition, Medicare and managed Medicare in Long Term Care. Works collaboratively with Nurse managers and IDT to ensure that Care plans reflect the residentsí condition on an ongoing basis. Ensure that all Medicare residents are skilled. |
Reports To: Director of Tandet
Titles Supervised: N/A
Hours Per Week: 24 Hours
1. Conducts a comprehensive assessment in collaboration with resident, family and on all OBRA and Medicare assessments within the correct time frame. Verify validation reports with fiscal office.
2. Has correct assessments completed per regulations.
3. Works in collaboration with PT to establish ARD date for Medicare assessments.
4. Works in collaboration with Nurse managers to ensure that the care plan and MDS reflects the resident and Unit Manager/RN to sign off on MDS.
5. Review all Medicare documentation during the MDS lookback period to ensure the Medicare regs are followed.
6. Issue denial letters when resident no longer is being skilled for medicare and falls below Skilled Level of Care. Reviews all redeterminations requested, prepare for cases to be presented to ALJ from CMA.
7. Coordinates activity between HMO and third party payors toward assuring treatment plan is on target and that variances and exceptions are preapproved, i.e., any test ordered, antibiotics etc. Fax needed materials to Managed Care Insurance.
8. Attends IDT/URC meeting and meets weekly with OT/PT. Contact person for Evercare.
9. Educate staff to ensure that coding is accurate and nursing notes reflect skilled care.
10. Works in collaboration with coder to ensure proper coding on Medicare assessments for reimbursement.
11. Knowledgeable of the RUG coding, keep updated to changes on the MDS's. Lead transmitter to the State. Re-certifications on Medicare residents. Review medical records requested by CMA.
12. Other related duties as assigned.
13. On Call and cover as floor nurse as needed.
Education: Graduate of a school of professional nursing; BSN preferred.
Experience: Strong clinical background in nursing; Head nurse, Care planning and MDS experience and fluency
Licensure: RN, State of Connecticut, CPR certification/IV line management
Ability to handle multiple demands and deadlines. Ability to read and communicate effectively; Ability to utilize various software packages to carryout position responsibilities.
This description of responsibilities is intended to reflect the major responsibilities and duties of the job, but is not intended to describe minor duties or other responsibilities as may be assigned from time to time.
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