Regional MDS Coordinator

Full-Time

About the Role

The Regional Reimbursement role is responsible for managing clinical leadership teams in the development, implementation, coordination, and evaluation of MDS services across multiple facilities. This position supports quality care and fiscal responsibility through comprehensive MDS training and support services for the assigned region. The role ensures training and program review of MDS Services in accordance with Federal, State, and Local laws and governing entity regulations.

Qualifications

• Currently licensed as RN in the state practiced.
• Associate or bachelor’s degree from an accredited nursing school required.
• Minimum of five (5) years in long-term or acute health care required.
• Minimum of five (5) years working as an MDS Nurse in long-term or acute health care.
• At least three (3) years of multi-facility, regional MDS experience.

Responsibilities

• Consults with and provides technical assistance to the MDS Coordinators through visits and the interpretation or clarification of policies and regulations.
• Trains new MDS Coordinators in conducting resident assessments, developing plans of care, evaluating residents’ responses to interventions, and documenting clinical records.
• Trains new MDS Coordinators on the RAI manual and all applicable deadlines for resident assessments and completion of Minimum Data Sets (MDSs).
• Observes MDS and related practices for compliance with standards and regulations.
• Regularly inspects the facility and nursing practices for compliance with standards of nursing practice and federal, state, and local regulations.
• May be required to assume the role of interim MDS Coordinator, as needed.
• Ability to train facility MDS regarding company best practices, including consistent coordination with other members of the Compliance Team (e.g., DON, BOM, Medical Records, and Therapy) to ensure compliant billing.
• Leads the facility management staff and consultants in developing and working from a business plan that focuses on all aspects of facility operations, including clinical management.
• Responsible for developing and implementing appropriate metrics and benchmarks for the company's quality of care, against which performance is evaluated.
• Regularly advises and directs the Clinical Support Team and Director of Nursing to maximize resident satisfaction and well-being.
• Develops and utilizes a standardized process to evaluate and evolve practice to decrease variability and improve the care and safety of patients.
• Responsible for developing, implementing, and monitoring quality management policies and procedures for quality data collection and reporting on QM measures.
• Conducts ongoing assessments of existing eligibility and referrals, case management, disease management systems, and Quality Management programs within each clinical setting. Provides objective evaluation and recommendations for those systems.
• Reviews existing clinic information system capabilities for the tracking and monitoring of quality indicators. Makes necessary adaptations for standardized reporting across all centers.
• Ensures Resident Assessment Instrument (RAI) guidelines are followed in the assigned region with a focus on resident care and financial reimbursement through the MDS process.
• Responsible for ensuring accurate and timely completion of resident assessments, in accordance with Medicare, Medicaid, OBRA, and other payer program requirements.
• Utilizes and manages the distribution and utilization of survey information to address areas of importance as defined by the community and service partners.
• Ensures regulatory compliance with all federal, state, and local regulations and laws relating to nursing home administration; guides facilities to operate within established company policies and practices.
• Ensures each facility maintains building and grounds to appropriate standards and that equipment and work areas are clean, safe, and orderly. Addresses any hazardous conditions and ensures Universal Precaution, Infection Control, Isolation, Fire Safety, and Sanitation practices and procedures are followed.
• Helps the Administrator prepare staff for inspection surveys, instructing staff on matters of conduct and disclosure, being interviewed by inspectors, immediate corrections of problems noted by surveyors, etc.
• Reviews and reinforces important standards previously cited.
• Participates in the preparation of the Plan of Correction response to an inspection survey and implements any follow-up QA required for any nursing allegations.
• Provides 24-hour “on-call” service to the nursing center in case of emergency.
• Assures that an adequate orientation and in-service training program is provided for MDS personnel.
• Other duties, responsibilities, and activities may change or be assigned at any time with or without notice.