Regional MDS Consultant RN or LPN (Rockford County)

Regional MDS Consultant (RN) or (LPN)

Allure Healthcare Services is seeking an experienced and highly motivated Regional MDS Consultant (RN) or (LPN) to provide clinical reimbursement oversight and support for 8 skilled nursing facilities. This is an excellent opportunity for an accomplished MDS professional who thrives in a collaborative, fast-paced environment and enjoys mentoring clinical teams while driving reimbursement accuracy and regulatory compliance.

This is not a remote position and travel will be required.

Position Summary

The Regional MDS Consultant (RN) is responsible for overseeing the accuracy, timeliness, and regulatory compliance of the Minimum Data Set (MDS) process across multiple skilled nursing facilities. This position partners closely with facility leadership and MDS Coordinators to optimize clinical reimbursement, ensure compliance with CMS regulations, improve quality measures, and provide education and operational support.

The Regional MDS Consultant serves as the organization's clinical reimbursement expert, providing guidance on Medicare Part A PDPM reimbursement, Medicaid case mix, regulatory changes, audit preparedness, and best practices for documentation and assessment completion.

Key Responsibilities

• Provide regional oversight and support for the MDS process across 8 skilled nursing facilities.
• Serve as the primary clinical reimbursement resource for facility MDS Coordinators.
• Ensure accurate, timely, and compliant completion of all MDS assessments.
• Monitor Medicare and Medicaid reimbursement opportunities while maintaining regulatory compliance.
• Conduct routine facility visits to evaluate MDS performance, reimbursement accuracy, and documentation practices.
• Develop corrective action plans and provide coaching to improve outcomes.
• Conduct orientation and ongoing education for MDS Coordinators and interdisciplinary team members.
• Develop and maintain training materials, procedural guides, and MDS educational resources.
• Maintain current knowledge of CMS regulations, MDS updates, RAI Manual revisions, PDPM requirements, and state-specific reimbursement guidelines.
• Ensure regulatory changes are communicated and implemented across all facilities.
• Oversee CMS Targeted Probe and Educate (TPE), Additional Documentation Request (ADR), and other reimbursement audits.
• Analyze reimbursement trends, quality indicators, and operational metrics.
• Prepare weekly updates highlighting reimbursement issues, regulatory changes, best practices, and facility performance.
• Review facility reimbursement processes and advise Administrators and regional leadership regarding opportunities for improvement.
• Assist facilities during state and federal surveys and ensure survey readiness related to MDS and reimbursement.
• Attend regional meetings and provide ongoing operational support to facility leadership.
• Collaborate with nursing, rehabilitation, dietary, social services, restorative nursing, physicians, and interdisciplinary teams to ensure accurate assessment completion.
• Perform additional duties as assigned.

Qualifications

• Current, active, and unrestricted Registered Nurse (RN) or Licensed Practical Nurse (LPN) license.
• Minimum of 23 years of experience as an MDS Coordinator in a skilled nursing or rehabilitation setting.
• Previous regional or multi-facility MDS consulting experience strongly preferred.
• Extensive knowledge of:
• MDS 3.0
• RAI Manual
• PDPM reimbursement
• Medicare Part A
• Medicaid Case Mix
• CMS regulations
• Quality Measures (QMs)
• Care Area Assessments (CAAs)
• Nursing Facility Level of Care (NFLOC)
• Experience managing CMS TPE, ADR, and reimbursement audits.
• RAC-CT or RNAC certification preferred.
• Strong leadership, coaching, and communication skills.
• Excellent analytical, organizational, and problem-solving abilities.
• Ability to travel regularly between assigned facilities throughout the Quad Cities region.
• Proficiency with electronic medical records and MDS software.

Why Join Allure HCS?

At Allure Healthcare Services, we are committed to delivering exceptional care through clinical excellence, teamwork, and innovation. We invest in our leaders by providing the resources, collaboration, and support necessary to succeed while making a meaningful impact across our organization.

If you are an experienced MDS professional with a passion for education, reimbursement excellence, and improving resident outcomes, we encourage you to apply and become part of the Allure HCS leadership team.

Allure Healthcare Services is an Equal Opportunity Employer.