North Shore Health
Overview
North Shore Health is seeking an MDS Director - Full-Time. Lake Country Health Services is a leading provider of skilled nursing and rehabilitation services. As a member of 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. Trust, engagement, competence, respect and passion are values that guide our team. We are one of the leading employers and providers of post-acute care in the Midwest and we are seeking exceptional individuals to join our team. 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. Ensure assessments accurately reflect the physical, mental and psychosocial status of each resident and support optimal reimbursement through accurate RAI reporting. 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 Coordinate 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 Development Ensures Medicare claims relating to MDS pending and therapy pending errors are corrected Generate MDS audit reports as needed Implementation 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 acts 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 Safety
Knows and follows center rules Follows center dress and hygiene policies Demonstrates proper use of equipment. Reports equipment needs or repairs Follows center smoking policies Reports and documents any incidents or accidents of residents, staff or visitors to the appropriate center personnel Reports all hazardous conditions/equipment to Supervisor Performs duties, which may include transportation of residents, as assigned in Center Disaster Plan Uses required protective equipment Follows infection control standards, policies and procedures Resident Rights Knows Resident Rights. Helps residents/patients exercise and/or protect their rights Reports resident/patient complaints to management Maintains confidentiality of resident/patient information HIPAA Follows and adheres to center policies and procedures implementing HIPAA requirements for the privacy and security of protected health information Uses and/or discloses only the minimum amount of Protected Health Information necessary to complete assigned tasks Reports all suspected violations of company’s HIPAA policies or procedures to the Center Privacy Designee 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 and Abilities
Experience using MDS software and proficiency in Microsoft Office. Strong oral and written communication skills, organizational and project management abilities. Ability to interact effectively with residents, families, and staff. Working knowledge of the MDS and RAI process with an interest in Medicare, Medicaid, and other payor reimbursement systems. Employment Type
Full-time Seniority Level
Mid-Senior level
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North Shore Health is seeking an MDS Director - Full-Time. Lake Country Health Services is a leading provider of skilled nursing and rehabilitation services. As a member of 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. Trust, engagement, competence, respect and passion are values that guide our team. We are one of the leading employers and providers of post-acute care in the Midwest and we are seeking exceptional individuals to join our team. 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. Ensure assessments accurately reflect the physical, mental and psychosocial status of each resident and support optimal reimbursement through accurate RAI reporting. 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 Coordinate 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 Development Ensures Medicare claims relating to MDS pending and therapy pending errors are corrected Generate MDS audit reports as needed Implementation 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 acts 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 Safety
Knows and follows center rules Follows center dress and hygiene policies Demonstrates proper use of equipment. Reports equipment needs or repairs Follows center smoking policies Reports and documents any incidents or accidents of residents, staff or visitors to the appropriate center personnel Reports all hazardous conditions/equipment to Supervisor Performs duties, which may include transportation of residents, as assigned in Center Disaster Plan Uses required protective equipment Follows infection control standards, policies and procedures Resident Rights Knows Resident Rights. Helps residents/patients exercise and/or protect their rights Reports resident/patient complaints to management Maintains confidentiality of resident/patient information HIPAA Follows and adheres to center policies and procedures implementing HIPAA requirements for the privacy and security of protected health information Uses and/or discloses only the minimum amount of Protected Health Information necessary to complete assigned tasks Reports all suspected violations of company’s HIPAA policies or procedures to the Center Privacy Designee 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 and Abilities
Experience using MDS software and proficiency in Microsoft Office. Strong oral and written communication skills, organizational and project management abilities. Ability to interact effectively with residents, families, and staff. Working knowledge of the MDS and RAI process with an interest in Medicare, Medicaid, and other payor reimbursement systems. Employment Type
Full-time Seniority Level
Mid-Senior level
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