North Shore Health
Lake Country Health Services is a leading provider of skilled nursing and rehabilitation services. As a member of the North Shore Healthcare, we are part of the largest post-acute provider in the Upper Midwest with 70 skilled nursing and assisted living centers located throughout Wisconsin, Minnesota, Michigan, and North Dakota.
MDS Director
Summary/Objective: Responsible for the direction and administration of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payor program requirements. Ensures assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures accuracy of RAI to reflect optimal reimbursement for services provided; ensures appropriate documentation to report and support services provided and assessment accuracy.
Responsibilities
Oversees and coordinates the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations
Coordinating and leading the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team
Ensuring the face validity of all Minimum Data Sets before electronic submission
Combine the timely electronic submission of all MDS
Conducting a monthly review of a random sample of the MDS to ensure accuracy and internal consistency with the medical record
Coordinate the completion of each resident’s MDS in compliance with all State and Federal requirements
Calculate triggers and develop resident assessment protocols for initiation of care plan
Ensure MDSs are completed timely
Accurately identify each resident’s level of functioning in accordance with RAI manual guidelines
Ensure each MDS accurately identifies the lowest level of functioning allowable to maximize reimbursement opportunities as allowed by Federal and State Law
Ensure CNAs, nurses and other disciplines have accurately completed required clinical record documentation timely
Coordinate and assist with weekly interdisciplinary care conferences and Medicare meetings
Make necessary referrals to nursing and therapy departments
Maintain MDS and supporting clinical record documentation according to State and Federal requirements and in compliance with center policies/procedures
Review and assess all resident information (including hospital records) to accurately complete MDS scoring
Train nursing staff on responsibilities for timely and accurate clinical record documentation
Ensure Medicare claims relating to MDS pending and therapy pending errors are corrected
Generate MDS audit reports as needed
Verified Medicaid billing accuracy
Verifies and maintains accurate billing for HMO and VA residents
Compiles monthly and quarterly Medicare/ Medicaid default reports
Ensures MDS submission and report preparation, processing (CASPER, Validation Reports, etc.) and distribution
Identifies MDS/Census and AR errors for corrections for center billing information
Provides training on clinical software and Care Tracker
Participates in interdisciplinary care team
Stays current with state and federal regulatory changes
Complies with laws and regulations applicable to position and act in accordance with Center’s Compliance Program
Attends and participates in in-service training, performance improvement (PI) committees and other meetings as scheduled and directed
Knows and follows center rules
Qualifications
Required Education And Experience:
Registered Nurse (RN) in good standing with respective state licensing board
Clinical experience, education or specialty skills specific to geriatrics
Demonstrated competence in PPS assessment as well as OBRA compliance
Excellent clinical assessment skills
Excellent organization and independent decision-making skills
Knowledgeable and understands state and federal regulations and guidelines governing the practices of the center
Excellent interpersonal skills
Computer proficiency with Microsoft products
Preferred Education And Experience:
2+ years of previous experience
Experience in a fast-paced environment
Post-acute care or health care experience preferred
Skills, Knowledge and Abilities
Experience using MDS software and proficiency in Microsoft Office Word and email systems
Strong oral and written communication skills
Strong organizational and project management skills
Ability to work with all levels of employees
Ability to read, write, speak and understand English
Ability to relate positively with residents/patients, families, community members, volunteers and other center staff
Working knowledge of the MDS and RAI process with interest in Medicare, Medicaid, and other payor reimbursement systems
Demonstrates basic computer knowledge and aptitude to learn company applications
Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.
Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.
Seniority level Mid-Senior level
Employment type Full-time
Job function Business Development and Sales
Industries Hospitals and Health Care
Referrals increase your chances of interviewing at North Shore Health by 2x
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Jefferson, WI .
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MDS Director
Summary/Objective: Responsible for the direction and administration of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payor program requirements. Ensures assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures accuracy of RAI to reflect optimal reimbursement for services provided; ensures appropriate documentation to report and support services provided and assessment accuracy.
Responsibilities
Oversees and coordinates the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations
Coordinating and leading the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team
Ensuring the face validity of all Minimum Data Sets before electronic submission
Combine the timely electronic submission of all MDS
Conducting a monthly review of a random sample of the MDS to ensure accuracy and internal consistency with the medical record
Coordinate the completion of each resident’s MDS in compliance with all State and Federal requirements
Calculate triggers and develop resident assessment protocols for initiation of care plan
Ensure MDSs are completed timely
Accurately identify each resident’s level of functioning in accordance with RAI manual guidelines
Ensure each MDS accurately identifies the lowest level of functioning allowable to maximize reimbursement opportunities as allowed by Federal and State Law
Ensure CNAs, nurses and other disciplines have accurately completed required clinical record documentation timely
Coordinate and assist with weekly interdisciplinary care conferences and Medicare meetings
Make necessary referrals to nursing and therapy departments
Maintain MDS and supporting clinical record documentation according to State and Federal requirements and in compliance with center policies/procedures
Review and assess all resident information (including hospital records) to accurately complete MDS scoring
Train nursing staff on responsibilities for timely and accurate clinical record documentation
Ensure Medicare claims relating to MDS pending and therapy pending errors are corrected
Generate MDS audit reports as needed
Verified Medicaid billing accuracy
Verifies and maintains accurate billing for HMO and VA residents
Compiles monthly and quarterly Medicare/ Medicaid default reports
Ensures MDS submission and report preparation, processing (CASPER, Validation Reports, etc.) and distribution
Identifies MDS/Census and AR errors for corrections for center billing information
Provides training on clinical software and Care Tracker
Participates in interdisciplinary care team
Stays current with state and federal regulatory changes
Complies with laws and regulations applicable to position and act in accordance with Center’s Compliance Program
Attends and participates in in-service training, performance improvement (PI) committees and other meetings as scheduled and directed
Knows and follows center rules
Qualifications
Required Education And Experience:
Registered Nurse (RN) in good standing with respective state licensing board
Clinical experience, education or specialty skills specific to geriatrics
Demonstrated competence in PPS assessment as well as OBRA compliance
Excellent clinical assessment skills
Excellent organization and independent decision-making skills
Knowledgeable and understands state and federal regulations and guidelines governing the practices of the center
Excellent interpersonal skills
Computer proficiency with Microsoft products
Preferred Education And Experience:
2+ years of previous experience
Experience in a fast-paced environment
Post-acute care or health care experience preferred
Skills, Knowledge and Abilities
Experience using MDS software and proficiency in Microsoft Office Word and email systems
Strong oral and written communication skills
Strong organizational and project management skills
Ability to work with all levels of employees
Ability to read, write, speak and understand English
Ability to relate positively with residents/patients, families, community members, volunteers and other center staff
Working knowledge of the MDS and RAI process with interest in Medicare, Medicaid, and other payor reimbursement systems
Demonstrates basic computer knowledge and aptitude to learn company applications
Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.
Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.
Seniority level Mid-Senior level
Employment type Full-time
Job function Business Development and Sales
Industries Hospitals and Health Care
Referrals increase your chances of interviewing at North Shore Health by 2x
Get notified about new Managing Director jobs in
Jefferson, WI .
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr