MDS Coordinator

MDS Coordinator

Job Summary

We are seeking a detail-oriented and experienced MDS Coordinator / Clinical Reimbursement Specialist to oversee our facility's clinical documentation, care management, and reimbursement processes.

This role is pivotal in ensuring accurate and timely Minimum Data Set (MDS) assessments, optimizing Patient-Driven Payment Model (PDPM) utilization, and driving superior Quality Measure (QM) and Quality Assurance and Performance Improvement (QAPI) outcomes.

The ideal candidate will be a clinical expert with strong analytical skills and a commitment to maintaining the highest standards of resident care and regulatory compliance.

Key Responsibilities

Clinical Reimbursement & Compliance:


* PDPM Management: Provide expert oversight of weekly interdisciplinary PDPM meetings for skilled patients, monitoring the effective utilization of PDPM tools (e.g., Physician Diagnosis Verification, Admission/Discharge/Weekly CSR, PDPM Weekly Tracking Tool, Point Right) to ensure accurate case mix assignment and appropriate reimbursement.


* MDS Coordination: Ensure the accurate and timely completion and electronic submission of all MDS Assessments (Medicare PPS, quarterly, annual, significant change, etc.) according to federal and state regulatory timeframes.


* Documentation Integrity: Verify electronic submissions, perform necessary corrections, and maintain meticulous records.

Ensure completeness and thoroughness of documentation across all disciplines to meet regulatory and medical standards.

Care Management & Quality Assurance:


* Assessment & Care Planning: Assess the health status and level of care for all new admissions.

Coordinate interdisciplinary participation in completing assessments and developing comprehensive, individualized care plans.


* Care Conferences: Schedule and conduct resident care conferences in compliance with regulations, ensuring all MDS reviews are completed beforehand.

Assist disciplines in formulating and revising care plans and evaluating the achievement of desired resident outcomes.


* Quality Monitoring: Track and monitor Quality Measure (QM) and Quality Assurance and Performance Improvement (QAPI) performance monthly and quarterly, providing data analysis and clinical recommendations to facility leadership for optimal outcomes.

Training & Leadership:


* Training & Development: Provide comprehensive PDPM and MDS training to new MDS Coordinators and other relevant facility personnel.


* Level of Care Management: Manage all level of care changes within the facility, ensuring timely communication to all departments and the transmission of required forms to appropriate external agencies.


* Supervision: This position includes supervisory duties and requires leadership in mentoring staff and maintaining high standards of practice.

Qualifications

Education and Experience:


* Graduation from an Accredited School of Nursing (Bachelor of Science in Nursing preferred...