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Catholic Health · 3 months ago

RN MDS Supervisor- Clinical Reimbursement & Quality Management

Smithtown, NY

Full-time

Onsite

Mid, Senior Level

$135K/yr - $135K/yr

5+ years exp

Catholic Health is dedicated to providing compassionate care in the Smithtown area, with a focus on advanced health care and community service. The RN MDS Supervisor will play a vital role in ensuring accurate reimbursement for services while improving the quality of care and ensuring compliance with regulatory standards.

Health Care

Responsibilities

Review and analyze resident documentation to ensure accuracy and completeness for reimbursement purposes, including Minimum Data Set (MDS) assessments and other relevant documentation

Assist in the accurate coding and billing of resident care services to maximize reimbursement

Review and analyze submitted claims for accuracy and identify potential areas for improvement or appeal

Stay up-to-date on current reimbursement regulations and guidelines (e.g., Medicare, Medicaid) and ensure compliance

Analyze reimbursement data to identify trends and opportunities for improvement in care and documentation practices

Participate in the development and implementation of quality improvement initiatives to enhance resident care and outcomes

Collect, analyze, and report on quality data to identify areas for improvement and track performance

Lead or participate in quality improvement projects to address specific issues or concerns

Assist in the development and implementation of policies and procedures related to quality and reimbursement

Ensure compliance with relevant regulations and standards related to quality of care and resident safety

Review and ensure the accuracy and completeness of resident records, including assessments, care plans, and progress notes

Serve as a liaison between nursing staff, residents, families, and other healthcare professionals to ensure effective communication and coordination of care

Provide training to staff on documentation, coding, billing, and quality improvement processes

Assist with internal and external audits related to quality and reimbursement

Identify and resolve issues related to reimbursement and quality of care

Qualification

MDS experienceClinical nursing experienceReimbursement regulationsPRI Assessor certificationData analysisCommunication skillsInterpersonal skillsOrganizational skillsAttention to detailTeamwork