Centralized MDS Coordinator

We are currently seeking a Centralized MDS Coordinator to join our team at the Avante Group, Inc corporate team! At our company, YOU are our greatest asset! Avante Group, Inc is seeking a Centralized MDS Coordinator responsible for coordinating and overseeing resident care across the continuum in the Skilled Nursing Facility (SNF) portfolio of companies. Ensures appropriate utilization of services, timely identification of clinical changes, accurate payer management, and compliance with regulatory requirements under CMS guidelines and PDPM reimbursement methodology. The Centralized MDS Coordinator works collaboratively with the interdisciplinary team to support and oversee safe and timely discharge planning, reduce avoidable hospitalizations, and ensure accurate documentation, billing integrity, and payer compliance across assigned residents throughout the portfolio of companies. Why Avante? At Avante, we believe in providing the highest quality of care to our residents while fostering a supportive and rewarding work environment for our team. Benefits You’ll Love: Competitive Compensation Comprehensive Insurance Coverage (Medical, Dental, Vision and more!) Strong Retirement Plan for Your Future Paid Time Off & Holidays to Recharge Tuition Reimbursement – Invest in Your Education Health & Wellness Programs to Keep You Feeling Your Best Employee Recognition Programs – Win prizes & an annual cruise! A Collaborative Work Environment – We value your voice! (Employee surveys, check-ins, & town halls) Advancement Opportunities – Grow Your Career with Us! What we are Looking For: Must be at least eighteen (18) years of age Possess educational requirements outlined below Ability to read, write, and follow oral instructions in English Must be a Licensed Nurse (RN preferred; LPN with experience accepted) Must be computer literate and proficient in MS Outlook, Word, Excel, PowerPoint, and clinical systems such as PointClickCare (PCC) and related programs Must have excellent written and verbal communication skills Must possess ability to effectively communicate with residents, families, employees, vendors, and support agencies Must possess ability to remain calm under stress Must demonstrate strong clinical judgment, clinical and personnel management skills and critical thinking skills Must have experience in skilled nursing, case management, utilization review, or managed care preferred Knowledge of PDPM, Medicare, Medicaid, and managed care systems preferred Essential Job Functions: Manage and monitor daily clinical reports (e.g., Saiva AI report or equivalent) to identify residents at risk Identify and respond to changes in condition, ensuring timely notification to the interdisciplinary team (nursing, provider, MDS, therapy, and administration) Coordinate interdisciplinary care planning and participate in IDT meetings and care conferences Monitor and oversee insurance portals daily for authorization updates, coverage changes, and continued stay determinations Ensure timely documentation of payer updates in the medical record and communication to the care team Coordinate ensure, and verify timely delivery of Notice of Medicare Non-Coverage (NOMNC) per CMS requirements Initiate and manage the Detailed Explanation of Non-Coverage (DENC) process as required Collaborate with therapy, nursing, MDS, and social services departments and personnel to ensure appropriate skilled coverage, continued stay justification and make recommendations regarding same based upon current data and information Support accurate PDPM classification by ensuring documentation supports clinical and reimbursement accuracy Assist in ICD-10 validation and ensure clinical documentation supports coding accuracy Review payer assignment and collaborate with billing office of each facility to ensure accurate billing and payer integrity Review and support denial prevention and appeal processes with clinical documentation support Develop and coordinate safe discharge plans from admission through discharge protocols, and make any appropriate recommendations to leadership Arrange post-acute services including home health, DME, transportation, and followup care Educate residents and families on discharge planning and post-care expectations Ensure compliance with CMS regulations, state requirements, and facility policies Participate in Quality Assurance and Performance Improvement (QAPI) initiatives Support survey readiness, audits, and documentation compliance Perform all duties in a constant state of alertness and in a safe manner at all times Perform all other duties as assigned Education / Experience: Must be a Licensed Nurse (RN preferred; LPN considered with experience) – license must be active Possess an Associate Degree in Nursing (AAS or ASN) or Bachelor of Science in Nursing (BSN) or equivalent degree, diploma or certificate Experience in skilled nursing, case management, utilization review, or related field required Strong knowledge of PDPM, Medicare, and managed care strongly preferred Background Screening Requirement: This position requires background screening through the Agency for Health Care Administration (AHCA) Care Provider Background Screening Clearinghouse. Learn more: If you are passionate about a patient care and a rewarding work environment, Don’t Hesitate- Apply Today! Avante provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, Veterans' status, national origin, gender identity or expression, age, sexual orientation, disability, gender, genetic information or any other category protected by law. In addition to federal requirements, Avante complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Avante expressly prohibits any form of workplace harassment based on race, color, religion, sex, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, Veterans' status or any other category protected by law. Improper interference with the ability of Avante's employees to perform their job duties may result in discipline, up to and including, discharge. #J-18808-Ljbffr Avante Group