MDS Nurse - REGISTERED NURSE

Job Summary

We are seeking a dedicated and detail-oriented MDS Nurse - Registered Nurse to join our dynamic healthcare team. In this vital role, you will be responsible for conducting comprehensive assessments, ensuring accurate documentation, and coordinating care plans in accordance with federal and state regulations. Your expertise will support optimal patient outcomes by managing the Minimum Data Set (MDS) process, facilitating compliance with Medicare and Medicaid requirements, and promoting high standards of clinical documentation. This position offers an exciting opportunity to make a meaningful impact on patient care within long-term care, skilled nursing facilities, or hospital settings.

Responsibilities

• Perform thorough MDS assessments to evaluate patient needs, ensuring compliance with CMS (Centers for Medicare and Medicaid Services) guidelines and clinical documentation standards.
• Review and analyze medical records, clinical documentation, and coding (ICD-9, ICD-10, CPT) to support accurate case management and reimbursement processes.
• Collaborate with interdisciplinary teams to develop individualized care plans that meet regulatory standards and promote patient-centered care.
• Conduct utilization management activities, including discharge planning, prior authorization reviews, and medical management to optimize resource utilization.
• Maintain proficiency in EMR/EHR systems such as Epic, Cerner, Athenahealth, or eClinicalWorks for documentation review and data entry.
• Ensure compliance with HIPAA regulations, health regulation policies, and long-term care regulations while managing sensitive medical records.
• Support quality improvement initiatives by participating in HEDIS audits, clinical documentation improvement programs, and adherence to NCQA standards.

Qualifications

• Valid Registered Nurse (RN) license with current state licensure.
• Proven experience in long-term care facilities, hospitals (including ICU or trauma centers), or outpatient settings with a focus on inpatient or acute care environments.
• Strong knowledge of medical terminology, physiology, anatomy, and clinical documentation standards.
• Experience with PCC is preferred.
• Familiarity with Medicare regulations, CMS guidelines, DRG (Diagnosis-Related Group) coding, ICD coding (ICD-9/10), CPT coding, and medical records management.
• Knowledge of health regulation policies including HIPAA and state healthcare regulations related to medical documentation review and utilization review processes.
• Excellent organizational skills with attention to detail in documentation review and compliance activities.

Join our team as an MDS Nurse - Registered Nurse to advance your career while making a positive difference in patient lives! We are committed to fostering a supportive environment that values your expertise and dedication to quality healthcare delivery.

Expected hours: 40.0 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person