Everett, MA, 02149, USA
236 days ago
Case Mix Coordinator / Clinical Reimbursement
Hours (16) weekly. (Flexible schedule) We offer the Following: + Premium Compensation + Great Benefits Package + Fun, Family-Like Team, and Atmosphere! + Professional Growth & Stability + Innovative Training Programs Benefits: + 401(k) + Dental insurance + Health insurance + Paid time off + Vision insurance Case Mix Coordinator / Clinical Reimbursement LPN/RN. + The Case Mix Coordinator ensures all UDAs (nursing assessments) are scheduled in PCC prior to the ARDs with specific emphasis on GG and Monitors for timely completion of UDAs. + During the Assessment Reference period, the Case Mix Coordinator reviews GG documentation, Coordinates - GG usual performance coding with the Interdisciplinary Team. + The Case Mix Coordinator ensures MDS GG coding - usual performance correlates with the team final usual performance and supporting documentation is scanned into PCC under miscellaneous. + UDAs to be completed by the IDT include the following + BIMS – completed by Social Services + PHQ2-9 – completed by Social Services + Pain Interview – completed by nursing, MDS- to be scheduled /opened 5 days leading up to the ARD + Pain assessment – done by nursing + Norton – done by nursing + Quarterly/ Annual Assessment includes– (Falls, B&B, Norton, Pain elopement, oral) done by nursing + Oral assessment – annual assessment – completed by nursing + GG – Admission/ Quarterly/ Discharge/Annually + OBRA UDAs populate for admissions/ quarterly and annually – for MCR 5 days/ significant change MDS assessments – ensures the UDA are scheduled/ opened in PCC to support the MDS assessment. + Ensure care plans are present for all diagnosis with OBRA assessment for each resident- ensure care plan correlates with MDS with MDS GG section. + Ensures order to elevate head of bed is present on MAR/TAR ( you may be the one to set up the order) + Ensure respiratory assessments – pre and post Neb assessment and time of administration is scheduled appropriately on the eMar – (You may be the one to set up the PCC order) + Ensure Respiratory care plans has “elevate HOB”, Resp assessments etc. on the care plan + Identify behaviors and ensure Behavior documentation and Behavior care plans are in place to support behavior Add ons. + Identify residents meeting the SUD add on criteria and communicate to Social Services and billing – ensure supporting care plan is in place. + Audits and collaborate with the MDS coordinator to ensure the MDS assessments have supporting documentation for what is coded on the MDS ( like MMQ supporting documentation). + Communicate with Administrative and Nursing leadership if UDAs are not been completed- may be required to complete assessments if nursing is unable to complete due to staffing challenges. + May cover for the MDS nurse during vacations/ illness etc + Monitors GGs for completion and accuracy minimum 3 x weekly and ensure all Care cards are in place. + R esponsible for compliance and reimbursement maximization. + Reports directly to the facility Director of Nursing /Administrator and to the Corporate Director of Clinical Operations. Attends the following meetings + PDPM/ Behavior Meeting + Morning meetings + QAPI Minimum Job Skills / Licensure + Must hold a valid RN/LPN MA License + MMQ Experience preferred + Vaccination per CDC and MA DPH guidelines
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