North Shore Healthcare
MDS Director
Lake Country Health Services is part of North Shore Healthcare, the largest post‑acute provider in the Upper Midwest with 70 skilled nursing and assisted living centers throughout Wisconsin, Minnesota, Michigan, and North Dakota. The MDS Director will lead the Resident Assessment Instrument (RAI) process to ensure accurate, timely completion of resident assessments in compliance with Medicare, Medicaid, OBRA and other payor program requirements.
We are seeking an experienced RN who excels in geriatric assessment, has strong organizational skills, and can collaborate with interdisciplinary teams to maximize reimbursement and quality of care.
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 and support optimal reimbursement for services provided.
Essential Functions
Oversee and coordinate the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations.
Coordinate and lead the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team.
Ensure face validity of all MDS before electronic submission and conduct monthly reviews of a random sample to verify accuracy with the medical record.
Coordinate completion of each resident’s MDS in compliance with all State and Federal requirements, including:
Calculate triggers and develop resident assessment protocols for care plan initiation.
Ensure timely completion of MDS.
Accurately identify each resident’s level of functioning per RAI manual guidelines.
Confirm that MDS reflect the lowest level of functioning allowable to maximize reimbursement.
Ensure accurate clinical record documentation by CNAs, nurses, and other disciplines.
Coordinate weekly interdisciplinary care conferences and Medicare meetings.
Make necessary referrals to nursing and therapy departments.
Maintain MDS and supporting documentation in compliance with state, federal, and center policies.
Review and assess all resident information, including hospital records, to complete MDS scoring.
Train nursing staff on timely and accurate clinical documentation.
Develop and correct Medicare claims related to pending MDS and therapy errors; generate MDS audit reports as needed.
Validate Medicaid billing accuracy, maintain accurate billing for HMO and VA residents, and compile monthly and quarterly Medicare/Medicaid default reports.
Identify and correct MDS/Census and AR errors, and provide training on clinical software and Care Tracker.
Participate in interdisciplinary care teams, attend safety trainings, and stay current with state and federal regulatory changes.
Comply with laws and regulations, center compliance program, and all relevant policies.
Adhere to center safety, infection control, and resident rights policies.
Follow only the minimum required HIPAA disclosures and report any suspected violations.
Required Education and Experience
Registered Nurse (RN) in good standing with the state licensing board.
Clinical experience, education, or specialty skills specific to geriatrics.
Demonstrated competence in PPS assessment and OBRA compliance.
Excellent clinical assessment, organizational, and independent decision‑making skills.
Knowledge of state and federal regulations governing post‑acute care.
Excellent interpersonal and computer proficiency, especially with Microsoft Office.
Preferred Education and Experience
2+ years of previous experience in a similar role.
Experience in a fast‑paced post‑acute environment.
Post‑acute care or healthcare experience preferred.
Skills, Knowledge, and Abilities
Experience using MDS software and proficiency in Microsoft Office.
Strong oral and written communication skills.
Strong organizational and project management skills.
Ability to work with all levels of staff and communicate effectively with residents, families, and the community.
Working knowledge of the MDS and RAI process with a strong interest in Medicare, Medicaid, and other payor reimbursement systems.
Basic computer literacy and aptitude for learning new applications.
North Shore Healthcare is committed to respecting and celebrating the individual strengths of our employees and providing equal employment opportunities to all qualified applicants. All qualified applicants will be considered for employment regardless of race, color, religion, sex, national origin, age, disability, or any other protected status.
#J-18808-Ljbffr
We are seeking an experienced RN who excels in geriatric assessment, has strong organizational skills, and can collaborate with interdisciplinary teams to maximize reimbursement and quality of care.
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 and support optimal reimbursement for services provided.
Essential Functions
Oversee and coordinate the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations.
Coordinate and lead the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team.
Ensure face validity of all MDS before electronic submission and conduct monthly reviews of a random sample to verify accuracy with the medical record.
Coordinate completion of each resident’s MDS in compliance with all State and Federal requirements, including:
Calculate triggers and develop resident assessment protocols for care plan initiation.
Ensure timely completion of MDS.
Accurately identify each resident’s level of functioning per RAI manual guidelines.
Confirm that MDS reflect the lowest level of functioning allowable to maximize reimbursement.
Ensure accurate clinical record documentation by CNAs, nurses, and other disciplines.
Coordinate weekly interdisciplinary care conferences and Medicare meetings.
Make necessary referrals to nursing and therapy departments.
Maintain MDS and supporting documentation in compliance with state, federal, and center policies.
Review and assess all resident information, including hospital records, to complete MDS scoring.
Train nursing staff on timely and accurate clinical documentation.
Develop and correct Medicare claims related to pending MDS and therapy errors; generate MDS audit reports as needed.
Validate Medicaid billing accuracy, maintain accurate billing for HMO and VA residents, and compile monthly and quarterly Medicare/Medicaid default reports.
Identify and correct MDS/Census and AR errors, and provide training on clinical software and Care Tracker.
Participate in interdisciplinary care teams, attend safety trainings, and stay current with state and federal regulatory changes.
Comply with laws and regulations, center compliance program, and all relevant policies.
Adhere to center safety, infection control, and resident rights policies.
Follow only the minimum required HIPAA disclosures and report any suspected violations.
Required Education and Experience
Registered Nurse (RN) in good standing with the state licensing board.
Clinical experience, education, or specialty skills specific to geriatrics.
Demonstrated competence in PPS assessment and OBRA compliance.
Excellent clinical assessment, organizational, and independent decision‑making skills.
Knowledge of state and federal regulations governing post‑acute care.
Excellent interpersonal and computer proficiency, especially with Microsoft Office.
Preferred Education and Experience
2+ years of previous experience in a similar role.
Experience in a fast‑paced post‑acute environment.
Post‑acute care or healthcare experience preferred.
Skills, Knowledge, and Abilities
Experience using MDS software and proficiency in Microsoft Office.
Strong oral and written communication skills.
Strong organizational and project management skills.
Ability to work with all levels of staff and communicate effectively with residents, families, and the community.
Working knowledge of the MDS and RAI process with a strong interest in Medicare, Medicaid, and other payor reimbursement systems.
Basic computer literacy and aptitude for learning new applications.
North Shore Healthcare is committed to respecting and celebrating the individual strengths of our employees and providing equal employment opportunities to all qualified applicants. All qualified applicants will be considered for employment regardless of race, color, religion, sex, national origin, age, disability, or any other protected status.
#J-18808-Ljbffr