Eden Senior Care
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MDS Coordinator/Case Manager
role at
Eden Senior Care .
This position is based at
Vista Senior Living Management , a dedicated branch of senior communities offering Assisted Living, Memory Care, and Independent Living services across multiple states.
Position Overview Position:
MDS Coordinator / Nurse Case Manager Seniority level:
Entry level Employment type:
Full-time Job function:
Health Care Provider
Essential Duties and Responsibilities
Coordinate resident assessment (MDS) according to RAI process and standards.
Conduct MDS interviews as assigned – Nursing and Social Services.
Complete the MDS in accordance with RAI process and standards.
Collaborate and educate the IDT on RAI needs regarding MDS completions, reimbursement, quality measures and other areas as needed.
Facilitate, coordinate, and participate in care conferences and regular care plan updates.
Educate staff as needed to ensure appropriate documentation for resident assessment.
Prepare for and conduct utilization review meetings with the IDT.
Participate in ICD‑10 coding for new admissions and subsequent diagnosis changes.
Coordinate with Managed Care Insurance organizations to ensure authorization requirements are met, providing prompt and detailed communication.
Manage communication and processes with ACOs and QIO appeals.
Serve as the point person for communication and collaboration regarding resident discharge planning with external providers and family.
Participate in company quality review processes including QAPI meetings and monthly quality assurance/QM metric meetings.
Deliver denial letters – NOMNCs and SNF ABNs in accordance with CMS guidelines.
Collaborate in grievance tracking and follow‑up.
Participate in morning stand‑up, clinical meetings, and end‑of‑day wrap‑up meetings.
Participate in monthly triple check meetings.
Manage facility psychotropic and behavior programs, including collaboration with MDs and pharmacy on GDRs, care planning, documentation, and evaluation of medication use.
Other duties as assigned or may be required.
Qualifications
Current license as an LPN/RN, able to practice in IL.
Strong knowledge of the MDS process.
2+ years’ experience preferred.
Strong knowledge of ICD‑10 coding/guidelines, Medicare Chapter 8 Manual, RAI Manual.
Preferably with social work experience or an understanding of discharge planning.
Good organizational skills.
Experience with Excel, Teams, or Zoom platform is a plus.
Excellent written and oral communication skills.
Valid CPR certification (willingness to obtain).
Keywords MDS, Reimbursement, RAI, Minimum Data Set, Medicare, Insurance, Medicaid, RNAC, AANAC, RAC‑CT, RNAC‑CE
#J-18808-Ljbffr
MDS Coordinator/Case Manager
role at
Eden Senior Care .
This position is based at
Vista Senior Living Management , a dedicated branch of senior communities offering Assisted Living, Memory Care, and Independent Living services across multiple states.
Position Overview Position:
MDS Coordinator / Nurse Case Manager Seniority level:
Entry level Employment type:
Full-time Job function:
Health Care Provider
Essential Duties and Responsibilities
Coordinate resident assessment (MDS) according to RAI process and standards.
Conduct MDS interviews as assigned – Nursing and Social Services.
Complete the MDS in accordance with RAI process and standards.
Collaborate and educate the IDT on RAI needs regarding MDS completions, reimbursement, quality measures and other areas as needed.
Facilitate, coordinate, and participate in care conferences and regular care plan updates.
Educate staff as needed to ensure appropriate documentation for resident assessment.
Prepare for and conduct utilization review meetings with the IDT.
Participate in ICD‑10 coding for new admissions and subsequent diagnosis changes.
Coordinate with Managed Care Insurance organizations to ensure authorization requirements are met, providing prompt and detailed communication.
Manage communication and processes with ACOs and QIO appeals.
Serve as the point person for communication and collaboration regarding resident discharge planning with external providers and family.
Participate in company quality review processes including QAPI meetings and monthly quality assurance/QM metric meetings.
Deliver denial letters – NOMNCs and SNF ABNs in accordance with CMS guidelines.
Collaborate in grievance tracking and follow‑up.
Participate in morning stand‑up, clinical meetings, and end‑of‑day wrap‑up meetings.
Participate in monthly triple check meetings.
Manage facility psychotropic and behavior programs, including collaboration with MDs and pharmacy on GDRs, care planning, documentation, and evaluation of medication use.
Other duties as assigned or may be required.
Qualifications
Current license as an LPN/RN, able to practice in IL.
Strong knowledge of the MDS process.
2+ years’ experience preferred.
Strong knowledge of ICD‑10 coding/guidelines, Medicare Chapter 8 Manual, RAI Manual.
Preferably with social work experience or an understanding of discharge planning.
Good organizational skills.
Experience with Excel, Teams, or Zoom platform is a plus.
Excellent written and oral communication skills.
Valid CPR certification (willingness to obtain).
Keywords MDS, Reimbursement, RAI, Minimum Data Set, Medicare, Insurance, Medicaid, RNAC, AANAC, RAC‑CT, RNAC‑CE
#J-18808-Ljbffr