Job Purpose:
To manage the RAI Process, adhering to Federal and State guidelines, and in accordance with
company’s policies and procedures
Essential job Duties and Responsibilities:
Manage Area or Programs:
Manage the RAI Process from resident admission to discharge in order to maintain clinical compliance and receive funding from Medicare, Medicaid and Managed Care pay sources. Responsibilities include MDS completion in a timely, accurate, documentation-supported and case mix optimized manner; development of individualized care plans reflective of the residents’ status; oversight of the resident care data collection tool; coordination of assessments and services by other clinical departments; liaison to rehab team; audit and survey preparation, implementation and response; managed care clinical authorization and justifications; State-required form completion; activities of daily living (ADL) training and support; restorative nursing program management and other duties related to case mix
management.
Meeting Management:
Responsible for managing the daily PPS/OBRA case management meetings; restorative/rehabilitation and level of care meetings. Attends daily start up, stand up, stand down and weekly standards of care meetings in order to identify resident changes that impact the MDS and/or Care Plan. Participates in
weekly standards of care meeting and monthly quality assurance and triple check meetings.
Clinical Support:
Supports the clinical goals of the facility and participates as a member of the nursing management team to maintain compliance with State, Federal and company Quality Assurance standards and
optimize the residents’ quality of life.
Resident Rights:
Understand, comply with and promote all rules regarding Residents’ rights.
Other Job Functions:
Staff Development:
Participate in in-service training, assist in implementing orientation programs and job skills training,
maintains professional competence
Other Duties:
Other duties as assigned
Physical and Sensory Requirements (with or without the aid of mechanical device):
Works in a climate-controlled and well-lighted environment.. Works in an office and throughout the building daily. Has Category 1 risk of exposure to infectious diseases, but receives training in handwashing practices and Universal Precautions and has access to personal protective equipment if direct exposure is anticipated. Is subject to interruptions, noise, and odors daily
Walking, reaching, climbing, bending, lifting, grasping, fine hand coordination, pushing and pulling, ability to distinguish smells, tastes and temperatures, ability to communicate with residents and employees, ability to understand and follow training, ability to instruct staff in service education, and the ability to remain calm under stress.
Qualifications:
Must be a Registered Nurse (RN) in good standing and currently licensed by the State.
Completion of post secondary education or other wise able to read, write and follow oral and written directions at a level necessary to accomplish the job.
Must be able to relate positively and favorably to residents and families and to work cooperatively with other associates.
Must be capable of maintaining regular attendance.
Prefer two years experience in long term care with a good working knowledge of Medicare/Case Management/Medicaid.
Must have knowledge of RAI Process, PPS requirements, Texas Case Mix, reimbursement forms and the necessary documentation.
Must have computer skills and proficiency.
Must have excellent communications and teaching skills in both individual and group settings.
Must be capable of performing the Essential Job Functions of this job, with or without reasonable accommodation
“At Will” Statement:
This job description provides guidelines only and none of its provisions are contractual in nature. The Job Description does not guarantee employment for any specific period of time or any specific terms or benefits of employment. All employment with the Company is “at will,” meaning that you or the Company may terminate the employment relationship at any time, with or without notice or cause. No member of the Company’s management staff has the authority to make oral or written promises of employment that are inconsistent with the policy of at-will employment. The at-will nature of employment may only be modified through a written employment agreement signed by the head of
the Company’s governing body and the team member.
Health Insurance Portability and Accountability Act (HIPAA):
Our Facility is committed to protecting the privacy, security and integrity of individually identifiable health information received from or on behalf of our employees. The Facility adheres to the highest standards of integrity in the performance of its business and is prepared to maintain compliance with HIPPA and other regulatory requirements by adopting and adjusting policies and processes as
necessary. All employees are required to adhere to all HIPPA regulations