Cedars Healthcare Center
– Cedars Healthcare Center, a member of the CommuniCare Family of Companies, is currently recruiting for anRN MDS Nurse
– Resident Assessment Coordinatorto join our team.PURPOSE/BELIEF STATEMENT:The RN RAC (Resident Assessment Coordinator) reports to the Executive Director and is responsible for accurate and timely completion of mds assessments and coordination of the RAI process.
Provides Medicare, Medicaid (case mix), and managed care oversight to ensure appropriate clinical services are provided and appropriate reimbursement is received for each resident.
This includes ensuring that the centers are in compliance with federal and state regulations as well as the CommuniCare Family of Companies guidelines and policies and procedures.
This role serves as a key member of the facilitys management team in helping the facility obtain/maintain quality outcomes.JOB DUTIES & RESPONSIBILITIESMDS scheduling and completion per RAI guidelines including coordinating care plan development and completion with the interdisciplinary teamDevelop an individualized, comprehensive resident care plan with the interdisciplinary team to ensure care area triggers are addressedEnsure care plans are reviewed quarterly and updated as needed to reflect current resident status with individualized problems, goals, and interventionsCoordinate with other disciplines to ensure timeliness of assigned sections of MDS completion and report noncompliance to Executive DirectorSignature of MDS sections V0200B comprehensive CAA completion and Z0500A MDS completionOversee clinical reimbursement and case management services within the center for Medicare A and B, managed care, insurance, and Medicaid (case mix)Direct and oversee the implementation of the CommuniCare family of companies programs, policies, and procedures related to the RAI process to ensure appropriate care is rendered and appropriate reimbursement is obtainedCoordinate the timely and effective service delivery for all residents while ensuring quality clinical outcomes with appropriate reimbursementAdvocate on behalf of the resident and facility for needed resident resources and servicesProvide education to other health care providers, the facilitys care team, and the resident/family on Medicare, Medicaid (case mix), managed care, and MDS completionWork as a liaison between the facility, the resident/family, rehabilitation, and other care providersOversee and monitor MDS documentation and charting requirements that support services provided to meet billing requirements including state specific requirements for supportive documentationProvide oversight of the medicare and managed care residents, coordinate rehabilitation and optimal recovery, and assist with discharge planningOversee the validation of Medicare entitlement and eligibility for prospective residentsComplete chart audits to assess the quality of the documentation to support skilled Medicare, managed care, and Medicaid coverageOversee the completion of certifications/recertificationsEnsure Medicare part A and B services are appropriately billed and meet medicare documentation guidelinesOversee the resource utilization of services covered under consolidated billing as well as ancillary costsDirect the completion of requests for additional information claims requests and appeal for denied Medicare, managed care, and Medicaid claimsPossess knowledge of facility managed care contract coverage guidelines, outliers, and contracts to ensure care is provided and billed appropriatelyAct as a liaison with the managed care plan provider to communicate resident needs while representing the interests of the facility and residentEnsure compliance with federal and state regulations, as well as the CommunCare Family of Companies policies and procedures regarding state specific case mixParticipate in facility meetings per policyOversee MDS accuracy and pertinent narrative data to support MDS assessmentPerform other duties as assignedConduct job responsibilities in accordance with the standards set in the code of conduct, policies and procedures, applicable federal and state laws, and applicable professional standardsQUALIFICATIONSGraduate of an accredited school of nursing; RNValid RN license in the state employedThree years of experience in a long term care environment preferredExperience with the MDS/RAI process and/or case management preferredBenefitsAs a CommuniCare employee you will enjoy competitive wages and PTO plans.
we offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers.
we also offer 401(k) with employer match and flexible spending accounts.About UsA family-owned company, we have grown to become one of the nations largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH).
Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities.
we have a single job description at communicare, “to reach out with our hearts and touch the hearts of others.” Through this effort we create “caring communities” where staff, residents, clients, and family members care for and about one another.COVID Vaccines are available for CommuniCare employees.
In conjunction with our pharmacy partners , we are currently offering free COVID vaccines to employees You can protect yourself, your family, and your community from COVID by getting vaccinated at no charge.