What are the responsibilities and job description for the Regional MDS Consultant position at NewGen Administrative Services?
Are you an expert in the Resident Assessment Instrument (RAI) process looking to elevate your impact? We are seeking a data-driven and clinically savvy Regional MDS Consultant to oversee quality and reimbursement outcomes across [Number] skilled nursing facilities in WA.
Pay: $120k-$200k DOE
In this strategic role, you will serve as the clinical liaison between facility MDS Coordinators and corporate leadership. You will ensure that our residents receive appropriate care plans while maximizing accurate Medicare/Medicaid reimbursement through rigorous audit and compliance.
Key Responsibilities
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Oversight & Compliance: Conduct monthly audits of MDS assessments (3.0) across regional facilities to ensure accuracy in RUGs/PDPM coding, CAA completion, and adherence to state/federal regulations.
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Clinical Reimbursement: Analyze ARD selection and assessment schedules to optimize reimbursement without compromising survey readiness.
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Training & Mentorship: Onboard and train facility MDS Coordinators and interdisciplinary teams on CMS updates, ICD-10 coding guidelines, and QAPI initiatives.
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Triple Check Process: Lead the regional "Triple Check" reviews for Medicare Part A, Managed Care, and PDPM to capture all therapy minutes and non-therapy ancillary charges.
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Survey Readiness: Serve as the regional expert during regulatory surveys; respond to Requests for Information (RFIs) and develop Plans of Correction (POCs) regarding clinical documentation.
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Data Analytics: Track 5-Star quality measures and identify trends in missed opportunities or high risk areas (e.g., falls, pressure ulcers, depression).
What You Bring
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Licensure: Active RN license in good standing (required). RAC-CT (Resident Assessment Coordinator-Certified) required within 12 months of hire.
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Experience: Minimum 3-5 years of experience as an MDS Coordinator in a skilled nursing facility (SNF/NF), plus at least 1 year of multi-facility or regional oversight experience.
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Technical Skills: Expert proficiency in MDS 3.0, PDPM, Medicare Part A/B, Managed Care billing nuances, and EMR software (e.g., PointClickCare, Matrix, NetHealth).
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Soft Skills: Ability to interpret complex regulations and teach them to diverse clinical teams; strong conflict resolution skills.
Salary : $120 - $200