MDS Case Manager (RN)

MDS/Case Manager (RN)

Elon Manor is looking for an MDS/Case Manager (RN) to join our team.

Position Summary

The MDS Coordinator is responsible for coordinating and overseeing the completion of the Resident Assessment Instrument (RAI) process, including Minimum Data Set (MDS) assessments, Care Area Assessments (CAAs), and interdisciplinary care plans to ensure compliance with federal and state regulations. The MDS Coordinator supports accurate clinical reimbursement, quality outcomes, regulatory compliance, and resident-centered care planning within the Skilled Nursing Facility. Accurate MDS completion directly impacts quality reporting and Medicare/Medicaid reimbursement.

Reports To:

Director of Nursing (DON) / Administrator

Qualifications

• Current FL RN license
• Minimum 23 years long-term care or skilled nursing experience preferred
• Previous MDS experience preferred
• Knowledge of: MDS 3.0 and RAI Manual, PDPM reimbursement methodology, Medicare and Medicaid regulations, Managed Care, OBRA requirements, Care planning process, ICD-10 coding principles, Quality Measures (QM)/5-Star Ratings, Electronic Health Record (EHR) systems (PCC preferred)
• RAC-CT certification preferred
• Strong organizational, analytical, and communication skills

Essential Job Duties and Responsibilities

MDS / Clinical Assessment Responsibilities

• Coordinate and complete MDS assessments per CMS and OBRA guidelines
• Ensure assessments are completed accurately and within regulatory timelines
• Coordinate interdisciplinary team participation in assessment completion
• Review resident medical records to ensure documentation supports MDS coding
• Monitor Assessment Reference Dates (ARDs)
• Complete Care Area Assessments (CAAs)
• Ensure individualized resident care plans reflect assessment findings
• Participate in resident care conferences and discharge planning meetings
• Maintain compliance with Resident Assessment Instrument (RAI) requirements

Reimbursement / Financial Responsibilities

• Optimize reimbursement under Medicare PDPM and Medicaid payment systems
• Review clinical documentation to ensure reimbursement accuracy
• Collaborate with therapy, nursing, dietary, social services, and physician teams regarding documentation needs
• Monitor skilled coverage documentation requirements
• Assist with Medicare and Managed Care documentation review
• Support facility Case Mix Index (CMI) management
• Identify reimbursement opportunities and documentation gaps

Regulatory / Compliance Responsibilities

• Ensure compliance with CMS, state, and federal regulations
• Maintain MDS transmission accuracy and timeliness
• Monitor Quality Measures and identify improvement opportunities
• Participate in survey readiness activities
• Assist with audit preparation and regulatory reviews
• Maintain current knowledge of CMS guidance and reimbursement changes
• Participate in Quality Assurance and Performance Improvement (QAPI) initiatives

Interdisciplinary Team Responsibilities

• Serve as resource and educator regarding MDS processes
• Collaborate with nursing, therapy, dietary, social services, and activities departments
• Participate in clinical meetings and Medicare meetings
• Educate staff regarding documentation standards
• Communicate resident status changes impacting reimbursement or care planning
• Promote interdisciplinary communication and resident-centered care planning

Physical Requirements

• Ability to sit for prolonged periods
• Ability to review charts and electronic documentation
• Occasional standing and walking throughout facility
• Ability to lift up to 25 pounds as needed

Performance Expectations

• Timely MDS completion rate
• MDS transmission accuracy
• Regulatory compliance adherence
• Quality Measure performance improvement
• Documentation accuracy
• Reimbursement optimization
• Survey readiness maintenance

About Us:

We provide outstanding care to our residents in a warm, nurturing environment that allows each resident to maintain his or her individuality and dignity. We pride ourselves on our professionalism and are constantly looking to be the best at what we do. Please join us and begin a rewarding and exceptional career.

We are an equal opportunity employer. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.