RN MDS Reviewer

Role Overview

• Supports successful completion and submission of the MDS (Minimum Data Set) to MassHealth
• Examines MDS assessments prepared by clinicians to ensure completeness, accuracy and appropriate explanation of functional status and related clinical findings
• Provides feedback to Clinical Care Manager to facilitate optimal documentation and, where necessary, rating category assignment
• Supports the Proxy MDS Reviewer (LPN) in completing Proxy MDS submissions for members who cannot be reached for assessment
• Completes portions of the electronic MDS-HC form based on diagnoses/information gathered from record review
• Prepares printed MDS forms for data entry
• Conducts routine training sessions for new Care Management staff and relevant Clinical Care Manager to drive high quality, consistent MDS assessments
• Conducts reviews in a timely way in accordance with all timeliness and quality standards
• Provides clinical care to members via telehealth technologies (video, chat, etc.)

Requirements

• Associates degree in nursing is required
• Bachelor's degree in nursing is preferred
• Five (5) years of experience working in an acute or long-term care setting required
• Experience working with MassHealth populations preferred
• Experience with care management platform preferred
• Ability to communicate effectively with clinical staff and physician offices
• Good technology skills, including use of electronic health records and Microsoft Excel
• Knowledge of MDS strongly preferred
• Deep familiarity with medical terminology
• Willing to learn and utilize telehealth technologies (video, chat, etc.)

Benefits

• Comprehensive total rewards package
• Health insurance
• Bonuses tied to company and individual performance