Regional Reimbursement Consultant

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Ensures that the facility is in compliance with the organization’s policy and procedures and complies with all state regulations
• Understands and implements company policies and procedures
• Ensures the accurate and timely completion of all MDS Assessments including PPS Medicare, quarterly, annual, significant change
• Participates in care conferences as need or requested by facility
• Provides clinical training and support to all staff
• Verifies electronic submissions of MDS, performs corrections when necessary and maintains appropriate records
• Congroles interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal and state standards
• Schedules and conducts resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews prior to resident care conference
• Assists disciplines in formulating and revising care plans. Ensures that resident’s present/potential problems are identified and prioritized; realistic goals are established and nursing intervention is appropriate
• Evaluates resident care plans for comprehensiveness and individuality
• Achieves or lacks achievement of desired outcomes. Ensures that resident’s care plan is reassessed and revised appropriately
• Responsible for all level of care changes within the facility. Notifies all departments when a level of care change has been made
• Generates appropriate forms to complete level of acuity and changes. Transmits forms to the appropriate agency for processing as required by state law
• Addresses complaints and resolves problems as needed

QUALIFICATIONS

• Bachelor’s Degree in Nursing required
• Five years management experience with experience in long-term care
• Must possess a current, unencumbered, active license to practice as an RN in the state
• General knowledge of professional basic nursing, restoratives and personal care services
• Ability to read and interpret documents, write reports, and correspondence
• Valid driver’s license
• High level of interpersonal skills to handle sensitive and confidential situations and documentation, and interaction with coworkers