Regional M.D.S. Nurse

Long Term Care company which serves Kentucky is seeking a Regional M.D.S. Nurse.

Responsible for the clinical aspects of financial optimization as it relates to assigned facility?s MDS (Minimum Data Set) completion, PPS (Prospective Payment System) processes, Medicare Denial of Payment activities and Medicaid payment. This process includes assessment, training and follow-up while assuring company standards are practiced and compliance with Federal and State regulations.

 

Responsibilities include but are not limited to:

1. Facility Assessment

a. Works in conjunction with Business Services and Budget Department to identify the financial risk/loss with the assigned facilities.

b. Review of facility operations impacting MDS, PPS, Medicare Denials, Medicaid and Financial Optimization.

c. Identifies the weaknesses and strengths of each facility in regards to Morning Meeting, ADL Scoring, ARD Selection, RUG Classification, Medicare Coverage (LOS), Hospital Lookback, MDS Completion, Skilled Documentation, Restorative Nursing, Physician Certifications and Accumax Utilization.

2. Training

a. Provides on-sight training and instruction to applicable facility staff in regards to areas of weakness as it relates to financial optimization of MDS, PPS, Medicare Denials and Medicaid.

b. Trains new MDS Coordinators on HHC Policies for MDS completion and Accumax utilization.

c. Provides Regional and Corporate training related to MDS Completion, PPS Operations, Medicare Denials, Medicaid Systems and Financial Optimization as requested by V.P. of Financial Operations.

d. Holds quarterly Regional MDS Coordinator meetings.

 

Qualifications:

1. Registered Nurse or Licensed Practical Nurse;

2. Previous experience long-term industry;

3. Must be knowledgeable of MDS, Medicare and Medicaid regulations governing long-term care;

4. Previous training experience at a regional and/or corporate level;

5. Computer skills- Windows applications; computer experience.

 

This position reports directly to the Director of Clinical-Financial Operations and V.P. of Financial Operations.

 

MISCELLANEOUS:

Up to 80% overnight travel required. Ability to travel by airplane.