Case Mix Coordinator / Clinical Reimbursement
Sodus Rehab & Nursing Center
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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