Minnesota Department of Health
Case Mix Reviewer - Nursing Evaluator
Minnesota Department of Health, Saint Paul, Minnesota, United States, 55199
Overview
The work you'll do is more than just a job. At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and improving the well-being and quality of life for all Minnesotans. This position conducts surveillance and evaluation of health care providers to audit a percentage of residents in Medicaid-certified long-term care facilities for coding accuracy of MDS assessment forms and the resulting Case Mix classifications. The role provides surveillance and guidance to health care providers based on compliance with state and federal laws and rules related to case mix review (CMR) audits. Responsibilities
Evaluate and conduct audits on health care providers to ensure accuracy of coding MDS assessment forms and the resulting Case Mix classifications. Document audit findings in the online Case Mix Review audit application. Complete Case Mix Review of special or expanded pool audits when requested by Case Mix Review Program Supervisor. Complete medical record reviews of certified nursing facilities for determining a facility's Institutions for Mental Diseases (IMD) status. The position is based out of the St. Paul office with most work time onsite performing surveillance of facilities primarily located in the metropolitan area of Minnesota. Occasional travel outside the base region is expected to survey facilities statewide. Most work hours are 8:00 a.m. – 4:30 p.m., Monday–Friday, with potential overnight travel based on audit workload. Reimbursement for authorized business travel expenses is provided according to bargaining unit guidelines. Minimum Qualifications
Current MN RN License AND Two (2) years RN experience in a health care setting with primary responsibility for assessing nursing and health needs and experience with documenting and writing reports. This experience must include evidence of documentation, reporting writing, or equivalent. A degree in Nursing, Public Health, Health Care Administration, Psychology, Social Work, Medical Field, Adult Education or closely related field may substitute for experience as follows: Master's degree: 18 months Bachelor's degree: 12 months Associate degree: 6 months Additional Qualifications
Organizational skills sufficient for scheduling and implementing an audit process. Ability to make decisions and solve problems independently. Ability to develop and maintain working relationships. Ability to stay calm in stressful situations or when dealing with frustrated, distraught, anxious or hostile individuals. Preferred Qualifications
Previous experience completing MDS assessments and familiarity with the Case Mix program. Previous experience in a leadership role. Physical Requirements
Involves transporting a laptop computer and Case Mix Review documentation/reference materials. Must be able to load/unload materials and equipment for onsite surveys; occasional travel outside the base region. Additional Requirements
Successful completion of a background study and employment reference checks. Travel is required; a valid driver's license is not required, but the candidate must meet travel needs. How To Apply
Select “Apply for Job” at the top of this page. For questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or careers@state.mn.us. For more information about the application process, visit http://www.mn.gov/careers. Contact: If you have questions about this position, contact Amy Winters at amy.winters@state.mn.us or 651-201-5617. For Connect 700 Program eligibility, apply online or email the Job ID, Working Title, and proof of eligibility to Amy Winters. If you need an accommodation for an interview, contact the Department of Health ADA Coordinator. Equal Opportunity
Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. All qualified applicants will receive consideration without regard to race, color, creed, religion, national origin, sex, pregnancy, disability, age, sexual orientation, gender identity, or other protected characteristics. About Health Department and Benefits
Come work for one of the best public health systems in the nation. We offer benefits including paid vacation and sick leave, holidays, health plans, retirement, life insurance, disability coverage, and professional development opportunities. Eligibility varies by employment type, agency, funding, and other factors.
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The work you'll do is more than just a job. At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and improving the well-being and quality of life for all Minnesotans. This position conducts surveillance and evaluation of health care providers to audit a percentage of residents in Medicaid-certified long-term care facilities for coding accuracy of MDS assessment forms and the resulting Case Mix classifications. The role provides surveillance and guidance to health care providers based on compliance with state and federal laws and rules related to case mix review (CMR) audits. Responsibilities
Evaluate and conduct audits on health care providers to ensure accuracy of coding MDS assessment forms and the resulting Case Mix classifications. Document audit findings in the online Case Mix Review audit application. Complete Case Mix Review of special or expanded pool audits when requested by Case Mix Review Program Supervisor. Complete medical record reviews of certified nursing facilities for determining a facility's Institutions for Mental Diseases (IMD) status. The position is based out of the St. Paul office with most work time onsite performing surveillance of facilities primarily located in the metropolitan area of Minnesota. Occasional travel outside the base region is expected to survey facilities statewide. Most work hours are 8:00 a.m. – 4:30 p.m., Monday–Friday, with potential overnight travel based on audit workload. Reimbursement for authorized business travel expenses is provided according to bargaining unit guidelines. Minimum Qualifications
Current MN RN License AND Two (2) years RN experience in a health care setting with primary responsibility for assessing nursing and health needs and experience with documenting and writing reports. This experience must include evidence of documentation, reporting writing, or equivalent. A degree in Nursing, Public Health, Health Care Administration, Psychology, Social Work, Medical Field, Adult Education or closely related field may substitute for experience as follows: Master's degree: 18 months Bachelor's degree: 12 months Associate degree: 6 months Additional Qualifications
Organizational skills sufficient for scheduling and implementing an audit process. Ability to make decisions and solve problems independently. Ability to develop and maintain working relationships. Ability to stay calm in stressful situations or when dealing with frustrated, distraught, anxious or hostile individuals. Preferred Qualifications
Previous experience completing MDS assessments and familiarity with the Case Mix program. Previous experience in a leadership role. Physical Requirements
Involves transporting a laptop computer and Case Mix Review documentation/reference materials. Must be able to load/unload materials and equipment for onsite surveys; occasional travel outside the base region. Additional Requirements
Successful completion of a background study and employment reference checks. Travel is required; a valid driver's license is not required, but the candidate must meet travel needs. How To Apply
Select “Apply for Job” at the top of this page. For questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or careers@state.mn.us. For more information about the application process, visit http://www.mn.gov/careers. Contact: If you have questions about this position, contact Amy Winters at amy.winters@state.mn.us or 651-201-5617. For Connect 700 Program eligibility, apply online or email the Job ID, Working Title, and proof of eligibility to Amy Winters. If you need an accommodation for an interview, contact the Department of Health ADA Coordinator. Equal Opportunity
Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. All qualified applicants will receive consideration without regard to race, color, creed, religion, national origin, sex, pregnancy, disability, age, sexual orientation, gender identity, or other protected characteristics. About Health Department and Benefits
Come work for one of the best public health systems in the nation. We offer benefits including paid vacation and sick leave, holidays, health plans, retirement, life insurance, disability coverage, and professional development opportunities. Eligibility varies by employment type, agency, funding, and other factors.
#J-18808-Ljbffr