Salary:
$100,300.00 per year
How to Apply:
Applications are submitted online until the position is filled and/or the posting is closed. After reviewing this job announcement, please click on the link at the bottom of the page to apply online. A resume is required with the application. Further instructions on submission of documents are available in the online application. A resume may not be substituted for an application.
Minimum Requirements:
- Registered Nurse (RN) with active state licensure AND a minimum of five (5) years’ experience in Minimum Data Sheet (MDS) assessment, Resident Assessment Instrument (RAI) process, and Patient Driven Payment Model (PDPM) reimbursement methodologies in a Long Term-Care environment.
- Three (3) years of nursing experience in a long-term care environment or healthcare consulting setting is preferred.
- Certification in MDS completion (RAC-CT) or similar accreditation is required at the time of appointment.
A current, valid Driver’s License is required for travel within Allegheny County as needed.
It is the policy of Allegheny County that in order to receive a final offer of employment, candidates must successfully pass a background check, which includes verification of Allegheny County Real Estate Tax status, and drug/medical examinations as required for the position
Position Summary:
Under the direct supervision of the Chief Nursing Officer, the Director of Clinical Coordination provides support, education, and training to assigned facilities on the Resident Assessment Instrument (RAI) process. The incumbent coordinates clinical operations in assigned facilities to ensure compliance with Medicare guidelines and managed care case management policy. This position is responsible for the regional coordination, development, and completion of the resident assessment process in accordance with the requirements of the Federal and States regulations as well as facility policy and procedure.
Overview:
Duties:
Essential Functions:
- Reviews MDS Detail and Resource Utilization Groups (RUGS) monthly or more frequently as needed for assigned facilities.
- Facilitates MDS training and MDS processes; reviews MDS issues and concerns during the survey process.
- Oversees and reviews Medicare entitlement and eligibility for prospective residents.
- Develops and implements programs that apply to the Prospective Payment Systems (PPS), Quality Measures (QM’s), Medicaid Case Mix and Medicare/Medicaid guidelines for all Supplemental Health Care (SHC) Stakeholders.
- Designs and presents RAI, PPS, Quality Measures, Medicare and Medicare education utilizing various types of media, technology, workshops, classes, and one on one.
- Conducts facility site visits to orient new MDS Coordinators as well as to evaluate and reinforce RAI/MDS/PPS processes.
- Provides onsite and remote support to facility teams.
- Ensures timely implementation of regulatory and reimbursement changes across all facilities.
- Serves as the organization’s subject matter expert for MDS, PDPM, Nursing Facility Level of Care (NFLOC), and reimbursement regulations.
- Performs other related duties as assigned.
Knowledge, Skills, and Abilities
Knowledge of:
- General nursing, rehabilitation, and restorative nursing, including medical practices in long-term care.
- Medicare/Medicaid regulations
- Nursing practices and procedures as well as laws, regulations, and guidelines governing nursing functions in long-term care.
Skill in:
- Microsoft Office Suite.
- Utilizing electronic health records (i.e. MDS software program, Matrix, etc.)
- PDPM guidelines
Ability to:
- Utilize good organizational skills.
- Demonstrate leadership.
- Plan, organize, develop, implement, and interpret programs, goals, objectives, policies, and procedures of clinical services.
- Demonstrate excellent communication and interpersonal skills, with the ability to collaborate effectively across teams.
- Be detail-oriented with a commitment to accuracy and compliance.
- Be the Subject Matter Expert (SME) in all MDS processes.
- Travel within Allegheny County as needed.
Residency:
Allegheny County within 1 year.
Veterans' Preference:
Will be awarded to eligible candidates.
AN EQUAL OPPORTUNITY EMPLOYER - M/F/V/D