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Tarrytown Rehabilitation & Nursing Center Case Mix Coordinator / Clinical Reimbursement in Cambridge, Massachusetts

24 Hours weekly ( weekdays)

We offer the Following:

  • Premium Compensation

  • Great Benefits Package

  • Fun, Family-Like Team, and Atmosphere!

  • Work in a Beautifully Remodeled Office

  • Professional Growth & Stability

  • Innovative Training Programs

Covid 19 Vaccine: Required

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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