Health Plan Nurse Coordinator I

MDS Coordinator (RN)We rely on our MDS Coordinator (RN) to coordinate or assist in the development and completion of the resident assessment process in accordance with the requirements of the federal and state regulations as well as company policy and procedures.Why Work For Us?Competitive payExcellent health benefits packagesCareer advancement opportunitiesEducation reimbursement program of up to $7,500 per yearBenefits & Conditions:No waiting period for enrollmentThree health plan optionsDelta DentalVSP VisionFree basic life insuranceDisability, critical illness, accident & legal coverage401(k) retirement planEmployee assistance programResponsibilities:Responsible for the completion of the resident assessment instrument per federal and state regulations and company policy and procedures.Acts as an in-house case manager by considering all aspects of the resident's care and coordinating services with physicians, families, third party payers and facility staff.Coordinates the development and completion of the resident assessment (MDS) in accordance with current federal and state rules, regulations, and guidelines that govern the resident assessment, including the implementation of RAPs and triggers.Selects the correct assessment reference date (ARD) and correct reasons for assessment that capture all resources utilized to ensure appropriate payment by the Medicare/Medicaid systems.Uses company standard systems (concurrent review when available) to manage the MDS process.Assists in the development of a comprehensive resident assessment and care plan.Communicates with the product champions to ensure that all new nursing employees are knowledgeable of the RAI process and receive the appropriate training as directed by their supervisor.Participates in the Medicare Part A in-house review as directed by their supervisors.Follows company standard regarding weekly communication with the business office manager on all information needed for Medicare/Medicaid billing.Qualifications:Registered nurse with a current, active license in the state of practiceMust hold and maintain a current CPR certificationMinimum two (2) years of clinical experience in a health care settingMinimum of one (1) year of experience in a long term care settingPrior experience as an MDS coordinator with demonstrated expertiseMust be capable of maintaining regular attendance