Requisition ID: 10448
Location: PLC Sacred Heart Home
515 North Main, Avilla, IN 46710-9410 United States (US)
Daily Hours: 8
Standard Hours: 40
Employment Status: Full-time
Employment Type: Regular
The Coordinator of MDS Care Management serves as Medicare Protective Payment System (PPS)/Medicaid resource for the facility. Oversees the completion and transmission of the Minimum Data Set (MDS) and the development of the plan of care for all patients/residents. Facilitates medical record documentation that accurately and thoroughly describes the patient's condition and intensity of services provided within the time frame mandated by federal regulations. Coordinates and directs performance improvement and program evaluation activities.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Ensures the initiation, completion and updating of the patient assessment instrument. Ensures that assessment information is accurately entered into the computer system and is transmitted within the time frames as mandatory regulatory requirements.
Works with the health care team members to verify that both the medical record and the assessment instrument accurately reflect the patient's status at the time of assessment, intensity of services provided and appropriate medical necessity for the services rendered to the patient.
Monitors services provided and selects appropriate diagnosis for coding. Verifies the coding of the patient diagnoses and monitors percentage of patients with regulatory-agency-determined appropriate rehabilitation or skilled nursing diagnoses.
Ensures that correct Resource Utilization Group (RUG) classification is utilized for services needed and rendered to patient/residents and that the business office is informed of changes in RUG classifications.
Coordinates schedule of patient/resident's care planning conferences with the interdisciplinary team and invites family participation in the care planning process by issuing a written or verbal invitation to the conferences.
Coordinates the development of the interdisciplinary individualized plan of care for all patients/residents according to the mandates of the Federal and State regulations.
Serves as case manager for all Medicare and Managed Care patients/residents admitted to Medicare unit. Provides clinical services in the incumbent's respective discipline, i.e. Staff RN, PT, OT, and SLP.
Serves as an expert resource and educator to physicians and staff regarding the patient assessment instrument, third party reimbursement concepts and related processes. Stays abreast of and orients team onregulatory agency policies and computer system updates.
Coordinates performance improvement and program evaluation activities for the unit. Conducts quality improvement and statistical data collection and analysis to evaluate the various aspects of program performance such as clinical performance, efficacy, patient outcomes, coding and billing as related to the services needed and rendered.
Conducts in-services and continuing education of staff with emphasis on MDS, Care Planning, and Federal/State compliance.
Participates in development of nursing policies and procedures with other members of the nursing leadership team.
This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. Other duties may be assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Graduate of an accredited nursing program required.
Bachelor's degree in Nursing preferred. Experience working as a licensed professional in either a skilled nursing or acute rehabilitation setting preferred. Previous MDS experience preferred.
Certificates, Licenses, Registrations
Registered Nurse with a current Illinois License required. Basic Life Saving (BLS) certification required.
Certification as a Resident Assessment Coordinator (RAC-CT) through the American Association of Nurse Assessment Managers (AANAC) preferred or must be achieved within one year of hire.
Business Unit: PLC Senior Services
EOE of Minorities/Females/Vets/Disability