Qureos Mentor

The McGuire Group

<div>MDS Completion 
Shift: Per-Diem 
Rate: $42/hr.

JOB SUMMARY: 
The MDS RN coordinates Medicare, Managed Care and Medicaid activities at the facility. Educates Administrator 
and facility staff on innovative procedures to maximize utilization and reimbursement through the completion of 
the MDS, care plan and care guide process. Supervises LPN MDS work and cosigns any MDS completed by an 
LPN.
<div>
RESPONSIBILITIES: 
<ul><li>Provides education and assistance to facilities on Medicare/Medicaid related areas including eligibility,</li></ul>
certification, coverage, documentation, utilization and reimbursement. Assists facilities with initial 
certification procedures and follow-up of problem areas. 
<ul><li>Interacts with Medicare, Managed Care and Medicaid claims review unit and compliance unit to assist a</li></ul>
facility in complying with company procedures and federal, state and local regulations. Reports regularly 
to administration on issues and activities. Interacts with the Medicare and managed Care intermediares 
in areas of coverage and documentation. Assists in review and preparation of denied claims or 
administrative record reviews by outside intermediaries. 
<ul><li>Completes and assesses compliance with Medicare, Managed Care, Medicaid and third party payers and</li></ul>
company procedures. Establishes systems and programs designed to correct any non-compliance 
situation. Participates with any outside reimbursement audits to acquire first-hand knowledge of areas 
that might lead to system failures. 
<ul><li>Establishes and maintains current statistical data associated with the Medicare, Managed Care and</li></ul>
Medicaid programs by region. Cooperates with operations to monitor activities for contractor programs, 
i.e. therapies, utilization review. Reviews and maintains Medicare, Managed Care and Medicaid 
reference materials. 
<ul><li>Monitors and identifies utilization issues. Establishes systems and programs to maximize utilization and</li></ul>
reimbursement. Monitors compliance with third party policies and procedures for authorizations for 
payment and provision of services. 
<ul><li>Provides ongoing orientation and training to appropriate facility staff regarding the Medicare, Managed</li></ul>
Care and Medicaid and other contracted third party payers. Provides education regarding changes in any 
reimbursement program. 
<ul><li>PDPM reviews upon admission or re-admission or as indicated</li><li>Review of MDS completion for Medicare A MDS&rsquo; for compliance and accuracy</li><li>Gathers documentation for CMS audit requests and other audits as indicated</li><li>Reviews physician documentation for accurate ICD 10 coding, assisting to set and rank diagnosis for new</li></ul>
admissions and re-admissions 
<ul><li>MDS Integrity reviews as indicated.</li><li>MDS completion as needed</li><li>Other duties as assigned</li></ul></div><div> 

REQUIRED SKILLS &amp; ABILITIES: 
<ul><li>Demonstrates experience in reimbursement, PDPM and quality measures as associated with the</li></ul>
MDS assessment 
<ul><li>Demonstrates excellent time management and organization skills</li><li>Proven ability to lead and inspire teams, fostering a culture of excellence and continuous</li></ul>
improvement 
<ul><li>Excellent communication, interpersonal and problem-solving skills</li><li>Ability to effectively manage multiple priorities and meet deadlines</li><li>In-depth knowledge of regulatory requirements and standards of care in long-term care settings.</li></ul></div> 

QUALIFICATIONS: 
Education: Minimum: Associates degree in Nursing 
Preferred: Bachelor&rsquo;s degree in Nursing 
Experience: Minimum: 2 years of Long-Term Care Experience 
Preferred: 4 years of long-term care experience 
Licensure: NYS Licensed Registered Nurse (RN) current, unrestricted licensure 
Certification: RAC-CT certification preferred

Benefits:
<ul>
<li>Paid Time Off (PTO)</li>
<li>Health, Vision, and Dental Insurance</li>
<li>Life Insurance</li>
<li>Referral Bonus Program</li>
<li>Weekly or Same Day Pay Options</li>
<li>Supportive Work Environment</li>
</ul>
Apply today to be part of a team committed to delivering excellent care while supporting operational excellence in a friendly and collaborative environment
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities 
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.</div>

MDS Completion

Join The McGuire Group and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

The McGuire Group

ABOUT_COMPANY

MDS Completion