Registered Nurse Assessment Coordinator - Rnac

Company	Germantown HomeSee more
Address	Philadelphia, PA
Form of work	Full-time
Salary	$86,861 - $90,333 a year
Category	Education/Training

Job description

Job Overview:
The Registered Nurse Assessment Coordinator (RNAC) is responsible for the accurate and timely completion of all Medicare/Medicaid case-mix documents in order to assure appropriate reimbursement for care and services provided within the Facility. Conducts concurrent Minimum Data Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG) category. Oversees the overall process and tracking of MDS/Prospective Payment System (PPS) documentation and submission. He/she will integrate nursing, dietary, social recreation, restorative, rehabilitation and physician services to ensure appropriate assessment and reimbursement.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Assesses and determines the health status and level of care of all new admissions.

· Ensures the accurate and timely completion of all MDS Assessments including PPS Medicare, quarterly, annual, significant change.

· Communicates level of care for new resident to all disciplines.

· Coordinates interdisciplinary participation in completing the Minimum Data Set (MDS) for each new admission to facility according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal, state and medical standards.

· Maintains an accurate schedule of all MDS assessments to include the proper reference dates throughout the resident’s stay.

· Responsible for the data entry function to assure accurate data entry and electronic submission of MDS assessments.

· Verifies electronic submissions of MDS, performs corrections when necessary and maintains appropriate records.

· Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal and state standards.

· Schedules and conducts resident care conferences in compliance with state and federal regulations and ensures completion of all MDS reviews prior to resident care conference.

· Assists disciplines in formulating and revising care plans. Ensures that resident’s present/potential problems are identified and prioritized; realistic goals are established and nursing intervention is appropriate.

· Evaluates resident care plans for comprehensiveness and individuality.

· Assesses the achievement or lack of achievement of desired outcomes. Ensures that resident’s care plan is reassessed and revised appropriately.

· Responsible for all level of care changes within the facility. Notifies all departments when a level of care change has been made.

· Generates appropriate forms to complete level of acuity and changes. Transmits forms to the appropriate agency for processing as required by state law.

Resident Assessment Protocols (RAPS) and Care Planning

Coordinates completion of RAP Documentation.
Acts as resource for staff in the development of a written plan of care for each resident that identifies the problems/needs of the resident, intervention as appropriate, and realistic goals to be accomplished.
Evaluates care Plans for comprehensiveness and individuality.
Coordinates the review and revision of the resident’s care plan by the interdisciplinary team after each quarterly review or other assessment, assuring that the care plan is evaluated and revised.

Quality Integrity of the MDS Process

Assess and evaluates the outcomes of the MDS process to determine additional training, education and monitoring needs.

Validates that the documentation supports the MDS coding.
Conducts regular audits of the MDS process.
Implements all required forms, procedures and processes relative to job responsibilities.
Participates in the facility Quality Initiative.
Participates in utilization management review.
Assists in the development and implementation of related medical record documentation.

Revenue Optimization

Tracks all residents to determine continued and appropriate level of care eligibility by predicting subsequent RUG categories.

Participates in review of the pre-admission intake information to predict RUGs levels.
Performs concurrent MDS reviews to insure appropriate RUG category is achieved through the capture of appropriate clinical information. Identifies opportunities to enhance reimbursement.
Communicates with interdisciplinary team any changes in level of care.
Collaborates with Clinical Resource Manager and Case Mix Focus Team to identify opportunities for optimizing reimbursement.
Maintains communication with the Billing department to facilitate accurate and timely billing.