Expedite Technology Solutions LLC
Location
Atlanta, GA | United States
Job description
Job Summary:
- The Minimum Data Set (MDS) Manager oversees and ensures the MDS team and drives the completion of MDS in accordance with current rules, regulations, and guidelines for Crestview Health and Rehabilitation Center. This position works closely with the Crestview leadership team to align MDS operations with facility goals and directives.
Description: Other duties as assigned.
- Partners closely with the Business Office Manager and staff to manage the Appeals and Denials process and Recovery Audit Contractor (RAC) audits.
- The MDS Manager will develop, implement and monitor the standards of the MDS staff. While maintaining a team approach to the shared responsibilities, the MDS Manager will function independently as needed in all aspects of the MDS role.
- Provides direct supervision to all MDS employees and monitors MDS related activities and goals. Implements corrective action as needed in a timely manner.
- Partners closely with the Quality Manager to support and provide leadership in quality initiatives. Monitors for quality, utilization, readmissions and cost effectiveness, and provides outcomes reports to the Utilization Review Committee.
- Works with the Administrator and Director of Nursing to monitor utilization trends and implements plans to improve utilization performance. Carries out the annual utilization management program in conjunction with the medical staff and department managers.
- Oversees all points of entry (ambulatory surgery, observation, admission, ED case management, and Authorizations and Referrals).
- ccountable for MDS management, utilization review, restorative and managing MDS Coordinator staff.
Education: - Minimum of five years' experience in MDS including Prospective Payment Systems, which demonstrates ability to recognize level of care in patient settings and make decisions for placement within the continuum of care.
- Progressive experience in management, with demonstrated ability of supervision of multi-skilled personnel. Working knowledge and experience with Appeals/Denials process.
- Broad clinical background in acute and long-term care with knowledge of payer mix and contracting.
Skills/Cert/Licenses: Required:
- Georgia Registered Nurse License
- Knowledge of long-term care and skilled nursing
- Working knowledge of MDS utilization management software
- Working knowledge of an electronic medical record system and technology, preferably Point Click Care
Preferred: - MDS Certification preferred.
Job tags
Salary
