Regional RAI Specialist

Job title: Regional RAI Specialist in Tennessee at PACS Group
Company: PACS Group
Job description: General PurposeThe primary purpose of your job position is to oversee the facility to ensure assessments are completed per guidelines. A primary focus is the resident assessment process, which includes individual assessment, MDS assessment, and resident plan of care.Essential Duties

• Provides oversight on facilities’ weekly PDPM meetings for skilled patients.
• Tracks and monitors each building’s effective utilization of PDPM tools (including but not limited to Physician Diagnosis Verification, Admission/Discharge CSR(GG), Weekly CSR, PDPM Weekly Tracking Tool, Point Right).
• Creates meaningful and effective clinical reporting systems between RDO and RDCS
• Holds Regional MDS workshops monthly on PDPM and other CMS related regulations.
• Tracks and monitors QM and QASP performance monthly and quarterly and provides data analysis and clinical recommendations to the facility for optimum outcomes.
• Assists RDCS in reviewing MDS/PDPM claims monthly for accuracy and in creating trend analysis of clinical areas for improvement.
• Provides PDPM and MDS trainings to new MDS Coordinators.
• Develops performance evaluation system for MDS Nurses in coordination with facility Administrators.
• Ensures all areas, which are triggered on the resident assessment protocol summary are included on the resident’s plan of care
• 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.
• Maintain the confidentiality of all resident care information including protected health information.
• Provides oversight on facilities’ weekly PDPM meetings for skilled patients.
• Tracks and monitors each building’s effective utilization of PDPM tools (including but not limited to Physician Diagnosis Verification, Admission/Discharge CSR(GG), Weekly CSR, PDPM Weekly Tracking Tool, Point Right).
• Creates meaningful and effective clinical reporting systems between RDO and RDCS
• Holds Regional MDS workshops monthly on PDPM and other CMS related regulations.
• Tracks and monitors QM and QASP performance monthly and quarterly and provides data analysis and clinical recommendations to the facility for optimum outcomes.
• Assists RDCS in reviewing MDS/PDPM claims monthly for accuracy and in creating trend analysis of clinical areas for improvement.
• Provides PDPM and MDS trainings to new MDS Coordinators.
• Develops performance evaluation system for MDS Nurses in coordination with facility Administrators.
• Ensures all areas, which are triggered on the resident assessment protocol summary are included on the resident’s plan of care
• 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.
• Maintain the confidentiality of all resident care information including protected health information.

Supervisory Requirement

• This position has supervision duties.

If you want to be a part of an amazing culture, while making a genuine difference, then this is the position for you!What to expect:

• Provide regional support, training and mentorship to MDS Coordinators in assigned region.
• Schedule - average week: provide on-site support 4 days/week, provide remote support 1 day/week

Successful candidates will have the following:

• RN license in good standing in Tennessee
• MDS certified - RAC-CT
• Recent experience with MDS 3.0
• Recent Experience in skilled nursing facilities

Physical DemandThe physical demands described here are representative of those that must be met by an employee tosuccessfully perform the essential functions of this job. Reasonable accommodations may be made to enableindividuals with disabilities to perform the essential functions.The employee must occasionally lift and/or move up to 25 pounds. Prolonged use of a desk top or laptopcomputer. While performing the duties of this job, the employee is regularly required to sit, stand; walk andtalk, read or hear. Frequent use of all office related equipment to include; copier/scanner/fax, telephone, and calculator. Travel by auto or airline may be required.Work EnvironmentThe work environment characteristics described here are representative of those an employee encounters whileperforming the essential functions of this job. Reasonable accommodations may be made to enable individualswith disabilities to perform the essential functions.The noise level in the work environment is usually low to moderate.Additional InformationNote: Nothing in this job specification restricts management’s right to assign or reassign duties andresponsibilities to this job at any time. Critical features of this job are described under various headings above.They may be subject to change at any time due to reasonable accommodation or other reasons. The abovestatements are strictly intended to describe the general nature and level of the work being performed. They arenot intended to be construed as a complete list of all responsibilities, duties, and skills required of employees inthis position.
Expected salary:
Location: Tennessee
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