RAI Director

Company: Presbyterian Homes & Services
Location: Roseville
Posted on: May 11, 2022

Job Description:

Presbyterian Homes & Services is seeking an RAI Director to join our team. The RAI Director is a regional role that is responsible for coordinating and overseeing the development and completion of the resident assessment process consistent with regulations and established clinical best practices across PHS designated care centers. Since this position supports multiple PHS locations, the person may office at the closest PHS site to their home, provided there is office space available. Reporting -Structure The RAI Director currently reports directly to the Vice President of Clinical Services and supervises MDS nurses and coordinates the resident assessment process with other health professionals. Responsibilities Some of the responsibilities of the RAI Director are:

• Hire, train and manage the performance of the MDS Nurses in your assigned region.
• For your assigned region, direct and ensure the development and completion of the resident assessment process with other health professionals consistent with regulations and established clinical best practices. Ensure timely, accurate and complete assessment of the resident's health and functional status during the entire assessment period
• Maintain an accurate schedule and assignments of all MDS assessments to include the proper reference dates throughout the resident's stay.
• Audit RUG grouper/MDS end splits, review all expedited appeals and ALJ level appeals. Perform concurrent MDS review to assure appropriate RUGs category is achieved through the capture of appropriate clinical information.
• Perform monthly QI/QM review for assigned region and provide recommendations to IDT and MDS Nurses.
• Complete triple check for assigned region (Review UB04's for clinical billing), review ancillary service charges.
• Determine denials/communications at IDT, track residents in 30 day window, monitoring regulatory compliance for completion.
• Participate in the interdisciplinary team process (IDT) to communicate opportunities, facilitate efficient and effective care plan development and management for your assigned region. -
• Specifically communicate (but not limited to): Medicare/Medicare Advantage admissions, changes to skilled services, PPS scheduled assessment ARDs, significant change in status assessments, PPS unscheduled assessment ARDs, Medicare beneficiary and Medicare Advantage Plan notices. Qualifications
  • Registered nurse with current licensure the State Board of Nursing in state(s) in which he/she practice
  • Previous long-term care experience with a working knowledge of the RAI process
  • Experience with MDS completion, reimbursement, clinical resource utilization and/or case management
  • Ability to work flexible work hours to support business requirements
  • Competency with standard office software applications as well as software applications related to MDS/RAI processes
  • High initiative and ability to efficiently and effectively lead interdisciplinary teams and coordinate and manage RAI process
  • Demonstrated compatibility with PHS's mission and operating philosophies
  • Demonstrated ability to read, write, speak and understand the English language to communicate with all customers. About PHS Presbyterian Homes & Services (PHS), based in St. Paul, Minnesota, is a non-profit, faith-based organization providing a broad array of high quality housing choices, care and service options for older adults. Over 7,000 employees serve 27,000 older adults through 50 PHS-affiliated senior living communities in Minnesota, Wisconsin and Iowa, and through Optage - home and community services. PHS is also co-owner of Genevive, a progressive model of primary care, care navigation and value-based services for over 5,300 older adults in Minnesota. Established in 1955, PHS has earned the reputation as an innovative leader concerned with promoting independence, vitality and well-being for those they serve. We believe employees are the most important resource in our ministry and we are committed to an environment where employees are valued and empowered to make a difference. With a strong commitment to grow our employees from within, the development opportunities with us are virtually unlimited. We offer competitive wages, opportunities for advancement, ongoing training, and incredible benefits like education assistance and nursing loan forgiveness. If you have a desire to honor God by enriching the lives and touching the hearts of older adults, consider answering the call and join our team. PHS is an EEO/AA employer. All applicants will receive consideration for employment regardless of their race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status, or status with regard to public assistance. Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.

Keywords: Presbyterian Homes & Services, Roseville , RAI Director, Executive , Roseville, California