MDS Education & Audit Specialist

Job Description

Job Description

MDS Education & Audit Specialist

Cascades Healthcare

Department: Clinical / MDS
Reports To: Vice President of MDS

Location: Utah (Corporate) / Multi-Facility Support

Travel: Regular travel to company facilities is required and may vary based on operational, training, and audit needs.

Position Summary

The MDS Education & Audit Specialist is an experienced MDS professional who supports the Vice President of MDS across all company facilities through accuracy and validation audits, education and training, and ongoing clinical support for facility MDS nurses.
This position requires a minimum of three years of dedicated skilled nursing MDS
experience. The Specialist independently evaluates completed MDS assessments and supporting resident documentation, identifies accuracy and compliance concerns, delivers meaningful education, and helps strengthen MDS practices throughout the organization.
The Specialist works collaboratively with the Vice President of MDS, facility MDS nurses, Directors of Nursing, Administrators, therapy teams, and other members of the interdisciplinary team to promote accurate assessments, regulatory compliance, and consistent MDS practices across all facilities.

Essential Duties and Responsibilities
MDS Accuracy and Validation Audits

• Conduct detailed accuracy and validation audits of resident medical records and
  previously completed MDS assessments.
• Evaluate MDS coding and supporting clinical documentation for accuracy,
  completeness, and compliance, including identification of unsupported coding, under-coding, over-coding, documentation gaps, and inconsistencies that may affect regulatory compliance, quality measures, or reimbursement.
• Evaluate assessments for compliance with current RAI Manual requirements, CMS guidance, PDPM requirements, and organizational standards.
• Review assessment timing, Assessment Reference Dates, completion requirements, submission requirements, and other MDS-related deadlines.
• Validate documentation supporting PDPM components, including diagnoses,
  functional status, nursing services, therapy, non-therapy ancillary conditions, and other applicable clinical factors.
• Evaluate Section GG documentation and coding for accuracy and consistency with supporting clinical documentation.
• Review care plans and other resident documentation when necessary to validate assessment findings.
• Document audit findings clearly and communicate identified trends and concerns to the Vice President of MDS.
• Assist the Vice President of MDS and facility leadership with the development and monitoring of corrective action plans when audit findings identify recurring or significant concerns.

Education and Training

• Provide structured onboarding and training for newly hired MDS nurses throughout the organization.
• Assist new MDS nurses in developing competency in the RAI process, MDS coding, PDPM, care planning, documentation requirements, assessment scheduling, and applicable regulatory requirements.
• Provide ongoing continuing education for facility MDS nurses.
• Develop and deliver education based on audit findings, regulatory changes, identified trends, and organizational needs.
• Provide individual coaching, targeted education, and remediation when knowledge or performance gaps are identified.
• Assist in developing standardized training materials, tools, reference resources, and MDS processes for use across facilities.
• Support facility MDS nurses in interpreting changes to CMS guidance, the RAI Manual, PDPM requirements, and other MDS-related regulations.
• Promote consistent MDS practices and expectations across all facilities.

Facility and Clinical Support

• Serve as a clinical MDS resource for facility MDS nurses and interdisciplinary team members.
• Provide guidance on complex MDS coding, assessment timing, documentation, PDPM, and care-planning questions.
• Partner with facility leadership to identify and address MDS documentation and process concerns.
• Assist with preparation for and response to regulatory surveys, audits, medical reviews, and other MDS-related reviews as directed by the Vice President of MDS.
• Support facilities experiencing MDS staffing transitions, new-hire training needs, or identified performance concerns.
• Assist the Vice President of MDS with special projects, organizational initiatives, and other MDS-related activities as assigned.
• Maintain awareness of changes in federal and state regulations affecting skilled nursing MDS requirements and communicate relevant changes to appropriate team members.
• Promote collaboration between MDS, nursing, therapy, business office, and other interdisciplinary departments.
• Protect resident confidentiality and comply with HIPAA requirements.

Authority and Organizational Scope

• This is an organization-wide position supporting MDS operations across all company facilities. It is focused on audit, validation, education, training, and clinical MDS support rather than routine completion of a facility's day-to-day MDS workload.
• The Specialist does not function as the assigned MDS Coordinator for a specific facility except when temporarily assigned by the Vice President of MDS.
• The Specialist does not directly supervise facility MDS nurses or facility clinical leadership.
• The Specialist identifies issues, educates, coaches, and reports findings to the Vice President of MDS, who determines any further action.

Qualifications
Required

• Current, unrestricted RN license with multistate privilege where applicable, or ability to obtain required licensure or practice privileges in states supported by the position.
• Minimum of three years of dedicated MDS experience in a skilled nursing setting.
• Demonstrated proficiency with the Resident Assessment Instrument (RAI) and MDS process.
• Strong working knowledge of PDPM and its relationship to skilled nursing
  reimbursement.
• Demonstrated ability to review completed MDS assessments and supporting clinical documentation for accuracy and compliance.
• Strong understanding of CMS requirements and current RAI Manual guidance.
• Working knowledge of MDS-based Quality Measures and the relationship between MDS accuracy, quality reporting, and facility performance.
• Experience educating, training, mentoring, or coaching MDS nurses or clinical staff.
• Strong analytical and critical-thinking skills.
• Excellent written and verbal communication skills.
• Ability to independently identify concerns and clearly explain the clinical, regulatory, and reimbursement impact of findings.
• Ability to work effectively with facility leadership and interdisciplinary teams.
• Ability to organize and prioritize responsibilities across multiple facilities.
• Ability and willingness to travel to company facilities as needed.

Preferred

• Multi-facility auditing, training, or regional MDS experience.
• RAC-CT certification.
• Previous corporate, regional, or consulting MDS experience.
• Experience conducting formal MDS accuracy, compliance, or reimbursement audits.
• Experience developing and delivering MDS education and training programs.
• Experience supporting facilities through CMS audits, surveys, medical reviews, or other regulatory processes.

Knowledge, Skills, and Abilities

The successful candidate will demonstrate:

• Advanced knowledge of MDS coding and the RAI process.
• Strong knowledge of PDPM and the relationships among clinical documentation, MDS coding, reimbursement, and quality outcomes.
• Ability to interpret complex resident documentation and determine whether MDS coding is supported.
• Ability to recognize patterns and trends across multiple audits and facilities.
• Strong teaching and coaching skills, with the ability to adapt education to the experience level and needs of individual MDS nurses.
• Ability to provide constructive feedback while maintaining positive working
  relationships.
• Confidence working with experienced clinical leaders and MDS professionals.
• Strong attention to detail and commitment to accuracy.
• Ability to maintain confidentiality and protect resident and employee information.

Tools and Systems

• Proficiency with Point-Click-Care or a comparable skilled nursing electronic health record system.
• Microsoft Excel or equivalent spreadsheet software for audit tracking, data analysis, and trend reporting.
• Virtual meeting and training platforms for remote education and coaching.

Physical Requirements andWorking Conditions

The employee must be able to perform the essential functions of the position with or without reasonable accommodation. Essential functions include prolonged computer work and chart review, travel by car or air to company facilities, and walking and standing while on site at skilled nursing facilities.

The Specialist works in a combination of corporate office and skilled nursing facility settings, with remote work as approved based on operational needs. The Specialist has regular interaction with facility leaders, MDS nurses, interdisciplinary team members and, at times, residents and regulatory personnel.

Regular travel to company facilities is required and may vary based on operational, training, and audit needs.

Accountability

The MDS Education & Audit Specialist works under the direction of the Vice President of MDS and supports the organization's efforts to maintain accurate, compliant, and consistent MDS practices.
The Specialist is expected to exercise independent professional judgment when
reviewing resident records and completed assessments, and to escalate significant findings, trends, compliance concerns, and reimbursement risks to the Vice President of MDS.

This job description describes the general nature and level of work performed in this position and is not intended to be an exhaustive list of all duties and responsibilities. Responsibilities may be modified based on organizational needs, regulatory requirements, and changes within the MDS and skilled nursing environment.