Regional Clinical Reimbursement
Throughout Cuyahoga County, OH and Franklin County, OH
*Salary: $100K-$135K per year (depending on experience)*
Responsibilities:
- Ensures that the facility is in compliance with the organization’s policy and procedures and complies with all state regulations
- Understands and implements company policies and procedures
- Ensures the accurate and timely completion of all MDS Assessments including PPS Medicare, quarterly, annual, significant change.
- Participates in care conferences as need or requested by facility
- Performs comprehensive assessment on potential residents
- Provides clinical training and support to all staff
- Verifies electronic submissions of MDS, performs corrections when necessary and maintains appropriate records.
- Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal and state standards.
- Schedules and conducts resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews prior to resident care conference.
- Assists disciplines in formulating and revising care plans. Ensures that resident’s present/potential problems are identified and prioritized; realistic goals are established and nursing intervention is appropriate.
- Evaluates resident care plans for comprehensiveness and individuality.
- Assesses the achievement or lack of achievement of desired outcomes. Ensures that resident’s care plan is reassessed and revised appropriately.
- Responsible for all level of care changes within the facility. Notifies all departments when a level of care change has been made.
- Generates appropriate forms to complete level of acuity and changes. Transmits forms to the appropriate agency for processing as required by state law.
- Addresses complaints and resolves problems as needed.
Qualifications:
- Must have an Ohio RN license
- Must have experience as a Director of Clinical Reimbursement
- Must have MDS experience
- Must know MDS 3.0
- Must have regional experience in nursing home
- Must have long-term care/nursing home experience
- Must have strong clinical background and knowledge
- Must be willing to travel
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