RN/LPN Case Manager

About the role

Midtown Center for Health and Rehabilitation is seeking an experienced RN or LPN for our Case Manager position. Welcome to Midtown, our new and improved center located in the heart of Memphis, just up the road from the Memphis Zoo. We strive for top-quality resident care as well as employee satisfaction, believing that happy employees lead to happy residents. We nurture our own talent and love to promote from within, offering training programs, career development opportunities, and a supportive work environment that encourages personal and professional growth.

Summary: Conduct and coordinate the development and completion of the resident assessment process in accordance with the requirements of Federal and State regulations as well as Company policy and procedure.

Responsibilities

• Participate in Daily PPS meetings, weekly Medicare meetings, and month end meetings to assure federal billing requirements are met.
• Assist with the coordination and participate in the completion of the Resident Assessment Instrument in accordance with current Federal and State Regulations.
• Assist in completing 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.
• Collect information to complete the MDS 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 to Federal Regulations.
• If a member of the Interdisciplinary Team is absent, verify that 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 and are completed timely as set forth by Federal Regulations.
• 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 (CAs) must be completed timely according to Federal Regulations.
• The CAs must contain sufficient information that supports whether or not the Care Area triggered will be Care Planned.
• The CM 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 rationale.
• Consult the CAA Summary Sheet and verify that all triggered CAs and corresponding narrative summaries have been completed, dated, and signed by the appropriate disciplines.
• Using information from the MDS Assessment and CAs, 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.
• Ensure Care Plans 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.

Qualifications

• Licensed Practical Nurse (LPN) or Registered Nurse (RN) 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.
• 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.
• Effective verbal and written English communication skills.
• Demonstrated basic to intermediate skills in Microsoft Word, Excel, PowerPoint and Outlook, internet and Intranet navigation.
• Strong analytical and problem solving skills.
• Approachable, flexible and adaptable to change.