Managed Care Coordinator jobs in Chico, CA

POSITION DESCRIPTION:

Responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, and Federal, State and Certification guidelines, and all other entities as appropriate- Minimum Data Set, discharge and admission tracking, etc. With direction from the Director of Nursing and VP of Clinical Reimbursement, may coordinate information systems operations and education for the clinical department.

QUALIFICATIONS:

• Graduate of an approved RN / LVN program and licensed in the state of practice, required.

• Minimum of 2 years of nursing experience in a Skilled Nursing Facility preferred.

• Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required.

• Thorough understanding of the Quality Indicator process. Knowledge of the OBRA regulations and Minimum Data Set.

• Knowledge of the care planning process.

• Experience with MDS 3.0, preferred..

• Maintains current MDS status of assigned residents according to state and federal guidelines.

• Maintains the frequent and accurate data entry of resident information into appropriate computerized MDS programs.

• Completes accurate coding of the MDS with information obtained via medical record review as well as observation and interview with facility staff, resident and family members.

• Other duties, responsibilities and activities may change or assigned at any time with or without notice

RESPONSIBILITIES:

• Works in collaboration with the Interdisciplinary Team to assess the needs of the resident; Provides interdisciplinary schedule for MDS assessments and care plan reviews as required by governing agencies.

• Ensures that the Interdisciplinary team makes decisions for either completing or not completing additional MDS, assessments based on clinical criteria as identified in the most recent version of the RAI User’s Manual.

• Assist with coordination and management of the daily stand up meeting, to include review of resident care and the setting of the assessment reference date(s).

• Complies with federal and state regulations regarding completion and coordination of the RAI process.

• Monitors MDS and care plan documentation for all residents; ensures documentation is present in the medical record to support MDS coding.

• Maintains current MDS status of assigned residents according to state and federal guidelines.

• Maintains the frequent and accurate data entry of resident information into appropriate computerized MDS programs.

• Completes accurate coding of the MDS with information obtained via medical record review as well as observation and interview with facility staff, resident and family members.

• Other duties, responsibilities and activities may change or assigned at any time with or without notice.

FullShift Staffing provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.  This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.