Seniorlink, Inc.

  • RN MDS Reviewer

    Job Location US-MA-Quincy
    ID
    2019-2507
    Type
    Regular Full-Time
  • Position Summary:

    The RN MDS Reviewer is a member of the Clinical Innovation and Services (CSI) team and reports to the Director of Clinical Services in Massachusetts. This individual supports successful completion and submission of the MDS-HC (minimum data set-home care) and Physician’s orders to MassHealth for all Adult Foster Care (AFC) consumers served by Caregiver Homes. Serving a critical role in driving quality and consistency across the state, this position reviews MDS-HC assessments prepared by RN Care Managers to ensure completeness, accuracy and appropriate leveling of functional status as it relates to home based clinical assessments of patients. Where gaps occur, the RN MDS Reviewer provides feedback and recommendations to staff to facilitate optimal documentation and, when necessary, provides additional training and support to the field. Position has potential to be remote.

    What You Will Do:

    • Review MDS-HC forms and relevant physician’s summary/order forms (PSF/POF) to ensure completion, accuracy and appropriateness with regards to level of care needs for AFC services, in accordance with established time and quality standards; provide feedback to RN Care Managers as appropriate
    • Track, analyze, and report out on documentation findings; make recommendations for process improvement
    • Prepare MDS-HC, Physicians Order Form and Prior Authorization (PA) Request Cover Sheet for data entry
    • Conduct routine training on best practices for staff and leadership to drive quality and consistency
    • Stay current on MassHealth or Third Party Administrator (TPA) process changes; participate in relevant MassHealth or TPA trainings
    • Ensure compliance with applicable regulatory requirements, standards, policies and procedures; participate in audit functions and investigations

    What You Will Bring:

    • Associate's Degree in nursing required; Bachelor's Degree in nursing preferred
    • At least 5 years of experience working in home care or care management; Experience working with MassHealth populations preferred
    • Previous MDS experience required; MDS-HC experience preferred

    About Us:

    SOLUTIONS THAT BLEND HUMAN TOUCH WITH TECHNOLOGY …

    At Seniorlink, we’ve spent nearly twenty years helping risk-bearing entities deliver high-quality, person-centered care more efficiently with solutions that range from our intensive in-home care model, Caregiver Homes to our advanced care collaboration platform, Vela. Our success lies in streamlining how interdisciplinary care teams coordinate and provide care, with care collaboration solutions that foster greater engagement among family caregivers and patients, and better outcomes for patients and providers.

     

    To learn more about Seniorlink, click here.

     

    Seniorlink is an Equal Opportunity Employer.

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