Lead MDS Resource

Description

The Team is growing! We have recently made some internal moves/promotions and have a rare opportunity for a MDS Resource serving facilities in Southern Idaho Region. This is an exciting role who is offered the tools and autonomy to be successful. This is a hybrid position working with a variety of Skilled Nursing Facilities.

The MDS Resource provides consulting services to Cascadia facilities and facilitates consultant services consistent with established standards of practice and federal and state requirements. This role is responsible for training and validation of PPS process and case mix data for assigned facilities to optimize appropriate reimbursement based on clinical documentation. In addition, this role is responsible for maintaining current RAI knowledge, Medicaid, Medicare and regulations for post-acute assessment,

documentation, and reimbursement.

Note: All employees of Cascadia Healthcare are required to submit and be cleared to work in the facility per each

state’s specific background check requirements prior to contact with patients/residents.

Essential Functions

• Provides support to facility MDS Coordinators. Regularly reviews MDS Assessments and discharges.
• Oversees functions related to MDS 3.0, both regulatory and financial.
• Provides on-site consultation for RAI process and attends Medicare/Medicaid meetings.
• Reviews PPS and case mix data for assigned facilities to ensure appropriate utilization from medical record documentation.
• Knows and monitors the Managed Care contract coverage guidelines, outliers, and contracts, to ensure care is provided and billed appropriately.
• Supports the MDS Coordinators and participates in facility-level evaluation of the performance of the MDS Coordinators.
• Utilizes PCC and regularly interprets data from the system.
• Provides MDS training to assigned facilities, as indicated.
• Proactively monitors and reports on the following metrics for the assigned facilities (not all inclusive):MDS, CAA, and care plan completion, accuracy, and timeliness
• Medicare meeting process to include utilization review, weekly Skilled Services meetings and triple check
• Medicaid meeting process and CMI
• QRP calculation
• Appropriate lengths of stay for residents
• 30-Day post return to acute care ratings
• Correct reimbursement is obtained for appropriate care and service provided
• Quality Measures
• Five Star Ratings

Other Functions

• Performs other tasks as assigned.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct, its policies and procedures, applicable federal and state laws, and applicable professional standards.

Requirements

Education

Graduate of a RN program. Bachelor’s preferred.

Licenses/Certification

Registered Nurse (RN) license.

Certified MDS Assessment Coordinator (CMAC) or Resident Assessment Coordinator – Certified

(RAC-CT) strongly preferred.

Experience

At least two years in MDS Coordinator position required