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Presbyterian Homes & Services

Lead RAI Director

Presbyterian Homes & Services, Roseville, Pennsylvania, United States

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Lead RAI Director

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Presbyterian Homes & Services

Overview PHS Management division is seeking a full‑time Lead RAI Director to join its team. This position is responsible for the coordination of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payer program requirements for assigned regional care centers. The Lead RAI Director ensures that assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures appropriate documentation to report and support services provided and assessment accuracy; communicates effectively with other members of the interdisciplinary team and manages the activities and performance of the MDS nurses in the assigned region.

Reporting Structure The Lead RAI Director reports directly to the Director of Care Center Clinical Services or designee. The Lead RAI Director supervises MDS nurses and coordinates the resident assessment process with other health professionals.

Responsibilities

Assist with training, mentoring and orientation of other RAI Directors, as requested.

Assist with coverage for open RAI positions, or when RAI directors are on leave or in need of additional support.

Observe and provide feedback to Director of Care Center on possibilities for site improvements.

Support startup for new openings of PHS buildings or acquisitions.

Work collaboratively with the Director of Care Center and the VP of Clinical Services to improve overall quality.

Scheduling of PPS and OBRA MDS assessments for assigned region.

Hiring, training, leading and managing MDS nurses.

Auditing RUG grouper/MDS end splits.

Reviewing all expedited appeals and ALJ level appeals.

Monthly QI/QM review for assigned region and provide recommendations to IDT and MDS.

Participating in Interdisciplinary Team meetings (IDT) for assigned region.

Completing triple check for assigned region (review UB04’s for clinical billing, review ancillary service charges).

Determination of denials/communicate at IDT.

Site‑specific education.

Key measure management.

Qualifications

Registered nurse with current licensure from the State Board of Nursing in the state(s) in which he/she practices.

5‑10 years as an RAI Director or similar position within the SNF setting. Previous long‑term care experience with a working knowledge of the MDS process.

Experience with MDS completion, reimbursement, clinical resource utilization and/or case management.

Ability to work flexible hours to support business requirements.

Competency with standard office software applications as well as software applications related to MDS/RAI processes.

High initiative and ability to efficiently and effectively lead interdisciplinary teams and coordinate and manage RAI process.

Demonstrated compatibility with PHS’ mission and operating philosophies.

Demonstrated ability to read, write, speak and understand the English language to communicate with all customers.

Travel Requirements:

This role may require regular travel to support sites with serious reimbursement/Quality Measure concerns along with the sites RAI Director.

Travel may include day trips, and in rare cases overnight trips.

Pay Range The estimated starting pay range for this role is \$88,110-\$107,169. This estimate is based upon PHS’ typical starting pay range for this role. Actual pay range depends on many factors including each individual employee’s qualifications and market conditions and is subject to change.

Benefits Full‑time benefits‑eligible employment begins at a minimum of 30 hours per week

Health, and dental, including applicable HSA & FSA

Employer Contribution to HSA for eligible Health Plans

Life insurance (AD&DD)

Retirement, with eligibility for an employer match

Holiday pay and extended sick leave

Full and Part‑time benefits‑eligible employment working between 20-29 hours per week

Vision insurance

Voluntary short‑term & long‑term disability

Accident & hospitalization coverage

Education assistance programs

All employees

Accrue PTO (Paid time off)

Same‑day pay

Employee assistance program (EAP)

College partnership educational discounts

Access to Learn to Live Resources

About PHS Based in St. Paul, Minnesota—Presbyterian Homes & Services (PHS) is a nonprofit, faith‑based organization providing a broad array of high‑quality housing choices, care options and services for older adults. There are over 7,500 team members like you at PHS, serving more than 26,000 older adults through 60+ PHS‑affiliated senior living communities in Minnesota, Iowa and Wisconsin, and through Optage® and other community services. PHS is also co‑owner of Genevive®, the largest geriatric primary care practice in MN, providing comprehensive care for over 15,000 older adults.

An innovative leader: Established in 1955, PHS has earned the reputation as an innovative leader dedicated to promoting independence, purposeful living, and overall well‑being. PHS is now one of the largest nonprofit senior housing and services providers in the US.

Our strong focus on our employees means we are committed to an environment where you are valued and empowered to make a difference. With a strong commitment to team growth from within, roughly 80% of leadership roles are filled through the development of people like you.

Seniority level Director

Employment type Full‑time

Job function Business Development and Sales

Industries Hospitals and Health Care, Mental Health Care, and Non‑profit Organizations

PHS is an EEO/AA employer. All applicants will receive consideration for employment regardless of their race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status, or status with regard to public assistance.

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