MDS Nurse Traveler - Northwest Louisiana (69407)

Description Traveling MDS Nurse – NORTHWEST LOUISIANA As a Traveling MDS Nurse, you will travel throughout PMGT regions as assigned / scheduled to support our facility teams with the MDS Coordinator role of coordinating and supporting the RAI process and assist as needed with comprehensive review and production of supporting medical records in response to Medicare, Medicaid, and Insurance audits/appeals; risk adjustment/quality reviews; and, as needed, assist with legal/personal medical records requests. Duties will be performed in accordance with State and federal regulatory requirements and our company’s established policies and procedures to assure that the highest degree of quality resident care and safety be maintained. You will work under the direction of the Director of Clinical Reimbursement and be responsible for the executive oversight of the administration, clinical planning, development, and operations of the facilities MDS program as assigned. This position supports regional and facility employees in all aspects of care management. ESSENTIAL DUTIES AND RESPONSIBILITIES: Assist assigned centers and demonstrated competency in the following area: (including but not limited to)

• Knowledge and assistance of the Minimum Data Set (MDS), Resource Utilization Groups (RUG’s), Triggers, Care Area Assessments (CAA’s), Plan of Care, Discharge Plan and documentation requirements per regulations and legislation.
• Proficiently coordinates and supports the RAI process.
• Initiates and monitors RAI process tracking, discharge/reentry and Medicaid tracking forms through the AHT LTC system.
• Completes patient assessments, data collection, and interviews staff as necessary to assure good standard of practice and as instructed in the current version of MDS User’s Manual.
• Ensures timely submission of the MDSs to the State with proper follow-up on validation errors. Maintains validation records from the submission process in a systematic and orderly fashion.
• Manages and collaborates with IDT on pre-admission screening, assignment of observation and look-back periods for the MDS completion including the implementation of a “significant change” MDS/plan of care processes.
• Performs data collection for the MDS process on all patients and reassessments as per the MDS scheduled requirements unless these are assigned to other clinical disciplines for completion.
• Assists in development and revision of plan of care as indicated by the patient’s response to treatment and the effectiveness of the overall plan of care in collaboration with the interdisciplinary team.
• Proficiently manages the Quality Measure processes as related to the RAI process, VBP, QRP, and QIPP to ensure high quality resident care.
• Flexibly manage tasks to meet deadlines by re-prioritizing workflows in a production-oriented setting
• Employ critical thinking to identify/resolve issues and provide timely feedback regarding medical review processes
• Attend and participate in mandatory in-service training programs, workshops, seminars, etc., as approved / delegated.
• Ensure full compliance with HIPAA regulations
• Working knowledge of ICD-10, CPT coding, HCPCs, Consolidated billing, and MDS item coding for PPS/PDPM and OBRA assessments
• Respond appropriately to behavioral, medical, and fire safety situations
• Other duties as assigned

Qualifications

EDUCATION: Must be a graduate of an accredited school of nursing, currently registered with a state agency for nursing licensure, and hold a valid license in the state he/she is employed. QUALIFICATIONS/EXPERIENCE: Experience in geriatric/long-term care nursing documentation, Minimum Data Set (MDS) coding, and/or medical necessity reviews/appeals. Working knowledge of regulatory and payer requirements for reimbursement and reason(s) for denial of claims for Medicare, Medicare Advantage, or Medicaid. Completion of continuing education on subjects related to case management, regulatory requirements, restorative nursing, medical records documentation, legal aspects of documentation, reimbursement, and compliance. SKILLS/COMPETENCIES

• Analytical - Synthesizes complex or diverse information using experience and judgement to complement data
• Problem Solving – Identifies/resolves problems in a timely manner; develops solutions; works well in group problem solving situations
• Communication – Speaks/writes clearly and informatively; listens and gets clarification; responds well to questions; demonstrates group presentation skills, edits work for spelling and grammar; varies writing style to meet needs
• Quality - Demonstrates accuracy and thoroughness; excellent attention to detail with a critical eye to catch/correct mistakes and errors; applies feedback to improve performance; monitors own work to ensure quality
• Character - Demonstrates integrity in every aspect of work and dealing with others; consistently models desired behaviors and values established by the company; respects diversity of perspective in discussions and demonstrates an inclusive style; demonstrates concerns for job safety for self and others
• Organizational Support - Follows policies and procedures; completes administrative tasks correctly and on time; supports organization's goals and values
• Dependability - Follows instructions and responds to management direction; takes responsibility for own actions; keeps commitments and completes tasks on time or notifies appropriate person with an alternate plan

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