RN Float Specialist — MDS/RAI Coordination (4 days/wk)

We are looking to hire a float MDS professional - 4 days a week. Essential Functions Follow regulations to plan, schedule and assure completion of all components of the RAI process for each resident. Utilize medical record, patient assessment and interview, staff interview, family and caregiver interviews as well as the electronic record to assess patients. Utilize medical record, patient assessment and interview, staff interview, family and caregiver interviews as well as the electronic record to assess patients. Utilize software for completion of all RAI components Utilize software to transmit assessments Assure accurate completion of assessments Assure timely completion of all assessments Support IDT team to schedule and complete care plans reviews Complete all CAA’s that trigger and facilitate development of care plans that coordinate with CAA assessments and MDS assessments Attend meetings to determine changes in resident status to facilitate scheduling of required assessments, to include Significant Change assessments Maintains schedule of required OBRA and PPS assessments and communicate with IDT team Work with IDT team to plan resident discharges from admission through to discharge Assess resident and review medical record to determine appropriate diagnosis coding and enter codes in to software Complete diagnosis listings, sheets and modify diagnosis codes in relation to changes for patients. Coordinate skilled stay for patients following Medicare and Insurance guidelines and contract provisions for Managed Care Part C patients and Dual eligible skilled Medicaid residents as well as private insurance. Gather information for insurance authorizations and coordinate authorizations as needed. Gather information as needed for insurance re-authorizations and facilitate obtaining authorizations as needed. Facility contact for insurance updates Facilitate the weekly utilization review of patients on skilled services for Medicare A, Medicare B and insurance patients Review Triple Check components daily, weekly and monthly to assure compliance with skilled services regulations and contract stipulations. Facilitate team meetings and support for RAI components, Medicare cert components, diagnosis coding components and other areas as needed Participate in daily meetings with facility rehab coordinator to review minutes and ADL scores and to track COT needs as well as EOT needs for PPS assessments. Determine, along with IDT team, what the reason for skilled services will be and coordinate care with IDT team to assure providing these skilled services Initiation, completion of physician/practitioner certifications as needed and assure practitioner signatures and dates are completed. Support the ADR process, and medical records requests by gathering needed information to present to Medical records to complete requests. Review billing process monthly with BOM to assure all required components are accurately reflected on UB-04. State Specific: CMI, LOCD’s, tracking tools, Part B logs are completed monthly. Assure access and logins needed to gather and complete required components. Assure RAI components of regulations are in compliance MDS Focused surveys, coordinate RAI component. Five Star Rating System: QM’s and how to access and read reports. Support clinical by communicating QM flags on an ongoing basis. Support facility team in management of QM’s. Complete required in-services monthly. Complete MDS focused training as required. Qualifications Licensed Nurse in good standing, RN preferred Acceptable background check. Over 21 years of age. MDS experience preferred. Ability to read, write, comprehend and communicate in English, follow oral and written instructions. Must function independently and have flexibility, personal integrity and the ability to work effectively with residents, co-workers, managers, other personnel and support agencies. Able to deal tactfully with people, both in person and over the phone. Aptitude and ability to use office machines and computer. Able to make independent decisions and possess problem-solving skills. Able to exercise discernment and make sound judgments. Knowledge of medical symbols, abbreviations and terminology. Knowledge of nursing and medical practice and procedures, as well as laws, regulations and guidelines which pertain to long term care. #J-18808-Ljbffr Illuminate HC