Prospective Payment Systems (PPS) Coordinator - Sunnyview Rehab Hospital

Job Title

Prospective Payment System (PPS) and Quality Reporting Program (QRP) Coordinator for Sunnyview Rehab Hospital

Employment Type

Full time

Shift

Day Shift

Description

Sunnyview Rehabilitation Hospital is a 115-bed acute hospital specializing in physical rehabilitation. Each patient has a dedicated team of physicians, nurses, therapists and specialists... all focused on one goal... taking back what was stolen by a stroke, traumatic injury or disabling illness. We're proud of our rich history... and the role we play in the healing process. Our patients come to us when they need us most. Our compassionate staff is there with up-to-the-minute treatment modalities and cutting-edge technology. Sunnyview is the only nationally recognized specialty rehabilitation hospital in upstate New York. Patients travel to Sunnyview from 40 counties in New York State, as well as 10 other states, for our expertise, experience and technology... and our reputation. Our outcomes show that we help patients attain their greatest level of independence and provide them with the best chance of going home. Sunnyview is an affiliate of St. Peter's Health Partners.

Prospective Payment System (PPS) and Quality Reporting Program (QRP) Coordinator for Sunnyview Rehab Hospital

If you have a strong clinical background - licensed as RN, Occupational Therapist, or Physical Therapist and are looking for a non direct patient care position, please read further!

What You Will Do

The PPS coordinator is responsible for planning, developing and overall coordination of activities that support the Prospective Payment System (PPS) and Quality Reporting Program (QRP) processes for the inpatient rehabilitation units.

Responsibilities

• Assures compliance with all State and Federal requirements related to and oversees the accuracy and timely completion/transmission of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI).
• Coordinates staff education and training related to scoring and documenting observations of CMG and Quality Measures.
• Completes and transmits the IRF-PAI to iQies within specified timeframes dictated by CMS.
• Collaborates with rehab liaison and admitting physician to determine the anticipated case mix group (CMG) to be assigned to each patient admitted
• Collects pertinent demographic, clinical and quality data and enters it on the IRF-PAI.
• Communicates with coders within 4 days of admission to determine etiologic diagnosis and co-morbid conditions present on admission.
• Communicates estimated length of stay to case manager for discharge planning and discussion at case conference.
• Participates in all case conferences and reviews documentation concurrently throughout the stay to ensure accurate documentation of team conference discussion.
• Reviews codes as provided by health information management for capture of documented conditions.
• Tracks and reports regularly on 60% rule compliance.
• Collaborates with interdisciplinary members of the team.
• Assists with formulating a plan of care including expected outcomes for each patient based on diagnoses derived from patient assessments.
• Educates and trains staff, including physician, nurses, therapists, pharmacists and social workers regarding documentation requirements
• Educates and trains staff to accurately score current and prior level of function
• Completes GG competency training with all new rehab staff.
• Reviews documentation for inconsistencies in GG scoring.
• Ensures biennial completion of GG re-credentialing for appropriate staff members.
• Maintains a current knowledge of PPS and QRP regulations related to participation requirements for inpatient rehabilitation facilities.
• Participates in Quality Improvement Activities.
• Identifies performance improvement opportunities in collaboration with the rehabilitation leadership team.
• Actively participates in the development, implementation and evaluation of quality improvement action plans/monitoring.
• Actively participates in the development/modification and implementation of rehabilitation policies and procedures.
• Tracks and reports regularly on outcomes data generated through IRF-PAI submissions.
• Attends facility quality improvement meetings as required.
• Other duties as assigned.

What You Will Need

• MUST have a Current NY clinical license for RN, Physical Therapist, or Occupational Therapist (OTR). Would consider licensed Occupational Therapy Assistant, Physical Therapy Assistant, or LPN if has at least 5 years experience in Acute Rehab setting.
• Minimum of 3 years in clinical setting. 5 years of clinical experience in an acute inpatient rehab setting is preferred.
• Basic computer skills, including word processing, spreadsheets and familiarity with web based software applications.
• Working knowledge of the Medicare Prospective Payment System and working knowledge of ICD-10 coding, CMG classification and IRF-PAI preferred
• Must be able to demonstrate understanding of Medicare rules and regulations as they relate to inpatient rehabilitation facilities.
• Must be able to communicate effectively with individuals who have varying levels of education in order to accomplish goals.
• Must maintain compliance to all safety protocols and procedures as required by Trinity and Sunnyview.

Pay Range

$28.55-$42.00 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.