Director of MDS

at  HCN Healthcare Solutions

DIRECTOR OF MDS

A nursing home is seeking a Director of MDS.
The Director of MDS is responsible for the overall successful completion of the MDS process from admission to discharge in accordance to company policy and procedure, State and Federal guidelines, and all other appropriate entities.

REQUIREMENTS/QUALIFICATIONS:

• Current FL Licensed Registered Nurse
• MDS experience required and a working knowledge of Insurance contracts
• Utilization Review/Case Management

• Ensure collection of resident information to allow for future assessments, including physical and mental states
• Assume a leadership role in Quality Assurance and Performance Improvement activities
• Prepare and distribute clinical conference schedule
• Medicare determinations on new admissions and re-admissions
• Notify families and billing department regarding Medicare determinations
• Prepare and track Medicare certifications and recertification’s
• Ensure completion of all sections of facility MDS assessments
• Responsible for insurance (Managed Medicare, Managed Medicaid and Commercial) concurrent reviews
• Initiate and track insurance appeals for admission denials and continued stay
• Schedule UAS with Managed Medicaid providers on appropriate residents
• Track coverage for insured residents from admission to discharge
• Collaboratively and cooperatively work with the MDS department, as well as interdisciplinary team
• All other duties as assigned