Health Plan Nurse Coordinator I

MDS Coordinator (RN)

Summary:

Conduct and coordinate 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 procedure.

Benefits and Perks:

• Health Insurance
• Dental + Vison
• 401k
• Tuition reimbursement through ECPI
• Employee recognition programs
• Daily Pay
• Referral bonus

Essential Duties & Responsibilities:

• Meet physical and sensory requirements stated below, and be able to work in the described environment.
• Identify and participate in process improvement initiatives that improve the customer experience, enhance work flow, and/or improve the work environment.
• Lead or participate in Daily PPS meetings, weekly Medicare meetings, and month end meetings to assure federal billing requirements are met.
• Oversee the coordination and participate in the completion of the Resident Assessment Instrument (MDS, CAA's and Care Plan) in accordance with current Federal and State Regulations.
• Assist in completion of the Resident Assessment Instrument with the Interdisciplinary Team.
• Notify all Interdisciplinary Team members of the MDS Assessment schedule for all payer sources.
• Notify all Interdisciplinary Team members of changes to the MDS Assessment schedule for both all payer sources.
• Information to complete the MDS is to be collected using the medical record, bedside assessment, and staff, resident and/or family interviews.
• Develop and monitor a system to verify that all Interdisciplinary Team members have completed, dated, and signed the assessments according the Federal Regulations.
• If a member of the Interdisciplinary Team is absent the MDS Coordinator is to verify that the all sections of the MDS are complete, accurate, and attest to the accuracy of the sections.
• Review prior to closing and transmitting the MDS to assure all sections have been completed, dated, and signed according to Federal Regulation.
• Verify all MDS documents required either by Federal and/or State Guidelines or Organizational policy are easily available at all times.
• Validate the ARD and Reason for Assessment with Therapy Services prior to transmission.
• Assure MDS assessments are transmitted timely as set forth by the Federal Regulations.
• Review the Final Validation Note fatal records that were rejected and take appropriate action assuring a rejected MDS is accepted in the Federal Repository prior to end of month billing.
• Upon completion of the MDS the Care Area Assessments (CAA's) must be completed timely according to Federal Regulations.
• The CAA's must contain sufficient information that supports whether or not the Care Area triggered will be Care Planned.
• The CAA will clearly state whether the problem "will proceed to care plan" or "will not proceed to care plan."
• When it is determined that a triggered Care Area will not be care planned the reasoning for not proceeding must clearly indicate clinical rational.
• Consult the CAA Summary Sheet and verify that all triggered CAA's and corresponding narrative summaries have been completed, dated, and signed by the appropriate disciplines.
• Using information from the MDS Assessment and CAA's develop an Interdisciplinary Plan of Care.
• Review Plan of Care at least quarterly and with each Comprehensive Assessment to assure changes during the quarter are included and updated.
• Care Plans must contain problem, goals, and interventions.
• Lead or Participate in Interdisciplinary Care Plan meetings.
• Provide ongoing education of the RAI process to all interdisciplinary team members, direct and indirect caregivers, business office, etc. with all changes and as appropriate.
• Other special projects and duties, as assigned.

Job Requirements:

• Registered Nurse with required current state licensure.
• Minimum three (3) years of clinical experience in a health care setting; long-term care setting preferred.
• Must have a current/active CPR certification.
• Personal integrity and professionalism to work effectively with the Interdisciplinary Team, Patients, and Families.
• Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.
• Self-motivated to learn and master the RAI Process in an effort to attain or maintain the patient's highest practical level of function.
• Excellent analytical and deductive reasoning skills.
• Effective verbal and written English communication skills.
• Demonstrated basic to intermediate skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigation.
• Highest level of professionalism with the ability to maintain confidentiality.
• Ability to communicate at all levels of organization and work well within a team environment in support of company objectives.
• Customer service oriented with the ability to work well under pressure.
• Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity.
• Strong analytical and problem solving skills.
• Ability to work with minimal supervision, take initiative and make independent decisions.
• Ability to deal with new tasks without the benefit of written procedures.
• Approachable, flexible and adaptable to change.
• Function independently, and have flexibility, personal integrity, and the ability to work effectively with employees and vendors.

Physical and Sensory Requirements:

• Moderate physical activity:

• Push, pull, move, and/or lift a minimum of twenty-five (25) pounds to a minimum height of three (3) feet and be able to push, pull, move, and/or carry such weight a minimum distance of fifty (50) feet.
• Standing and/or walking for more than four (4) hours per day.
• Bending and/or stooping for more than one (1) hour at a time.
• Sitting for more than two (2) hours at a time.
• Requires writing and/or computer work with repetitive typing and concentrating on computer screen and/or documents for more than two (2) hours at a time.

About Eastern Healthcare Group:

Eastern Health Group is a family of skilled nursing facilities and rehabilitation centers. We are resident-centered and quality-focused! Our workplace culture is all about uplifting people. We are committed to creating a nurturing, family-like atmosphere where staff develop meaningful relationships with residents and where exceptional patient outcomes are the standard.