Job Requirements:

Graduate of an accredited School of Nursing (RN or LPN) with a valid state nursing license.
One year of long-term care clinical nursing experience is preferred.
Knowledge of RAI (Resident Assessment Instrument) requirements is preferred.
Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable.
Strong computer, interpersonal, leadership, organizational, and clinical skills.
Ability to communicate effectively with residents, their families and all levels of the organization.

Responsibilities:

Responsible for coordinating the development and completion of the RAI (Resident Assessment Instrument) in accordance with current Federal and state rules, regulations, and guidelines.

Directs the facility interdisciplinary RAI process.
Ensures the validity of all Minimum Data Sets before electronic submission. Assures consistency of documentation between MDS and medical records.
Ensures the timely electronic submission of all MDS assessments.
Reviews pre-admission orders and daily chart review for effective treatment management.
Disseminates any new or updated materials involving the RAI process.
Audits charts for appropriate Medicare documentation within the guidelines established by CMS.
Schedules residents for appropriate OBRA, Medicare PPS and/or Medicaid required assessment.
Completes hands-on assessments with each resident when needed.
Participating in various committee meetings (i.e., Quality Assurance) as required.
Providing training for nursing employees to ensure they are knowledgeable of the RAI process.
Communicating with the Business Administration office and Administrator on a regular basis regarding the case mix scores and how they impact reimbursement.
Serves as primary contact for Medicare/Medicare Advantage auditing. Gathers documentation and sends to appropriate agencies to complete audits in a timely manner.
Serves as primary MDS/clinical contact for Medicare billing vendor.
Coordinates section GG of the MDS with the Therapy and nursing teams.

Serves, as needed by special circumstance, as supplemental effort for…

Temporary absences of the QAPI/Infection Preventionist position.
All other duties as assigned.

Additional Responsibilities

Meets all resident and household needs by actively assisting (to the extent of cross training and certification) in all tasks of the household.
Ensures that resident rights and responsibilities are honored and met.
Monitors the community and household response to resident concerns through continuous quality improvement.
Maintains professional presence when representing Trinity Woods; exhibits degree of professionalism consistent with standards in performance, behavior, and appearance.
Demonstrates professional development/skills competency in all activities.
Complies with Trinity Woods’ established safety rules and practices.