Job Description
Job DescriptionRN MDS Reviewer
URGENT NEED! 3-6 month contract with possibility for extension
Schedule: Full-time (40 hours/week), Monday-Friday
Compensation: $70/hour (Hourly, Contract)
Work Location: Fully Remote
About Us:
Since our inception in 2019, Legacy Care Group has become a leader in Nurse Staffing Solutions and community-based healthcare operations in Massachusetts. As a nurse-led organization, we have established a reputation for our highly personalized and collaborative approach. Our expertise has enabled us to fulfill some of the largest emergent staffing requests in the state, creating a vast network of local nurse contacts and becoming a vital resource for healthcare institutions. We pride ourselves on our close partnerships with major organizations, delivering both emergent and non-emergent healthcare staffing needs with precision and care.
Position Summary:
Legacy Care Group is currently looking for a qualified RN MDS Reviewer for Commonwealth Care Alliance (CCA). CCA's Assessment Unit is primarily responsible for developing and ensuring adherence to high quality, member-centric care plans through timely execution of community-based assessments for CCA members and ongoing tracking and monitoring.
The RN MDS Reviewer is a member of the Minimum Data Set (MDS) Clinical Review team of the Care Planning Unit. The RN MDS Reviewer supports successful completion and submission of the MDS to MassHealth / CCA. S/he will examine MDS assessments prepared by clinicians to ensure completeness, accuracy and appropriate explanation of functional status and related clinical findings. Where gaps occur, the RN MDS Reviewer provides feedback to Assessment RNs to facilitate optimal documentation and, where necessary, rating category assignment.
The RN MDS Reviewer reports to the Manager, Clinical Assessments.
Essential Duties & Responsibilities
- Reviews MDS forms completed by Nurse Assessors for completion and accuracy.
- Provides feedback to Nurse Assessors on areas where insufficient documentation is found or where rating category assignment is inaccurate.
- Completes portions of the electronic MDS-HC form based on diagnoses / information gathered from record review as needed.
- Conducts reviews in a timely way in accordance with all CCA timeliness and quality standards.
- Additional MDS-related tasks as required by supervisor.
Working Conditions
- Fully Remote position
Expectations for All Employees
Demonstrate integrity by working with passion, commitment, and honesty, acting in the best interests of colleagues and members. Approach work in a collaborating and caring manner interacting with insight, sincerity, and compassion. Demonstrate accountability by delivering on commitments, owning mistakes as well as successes, and contributing to an empowering environment where the focus is on solving problems and learning from errors. Recognize and respect diversity in all forms. Strive for excellence in the fulfillment of CCA's mission through quality, innovation, and continuous learning. Demonstrate initiative, flexibility, and openness to change. Represent CCA and its clinical affiliates with professionalism. Keep current and proficient with necessary skills and knowledge. Self-identify training and development needs relevant to work area and responsibilities. Adhere to all applicable compliance requirements including but not limited to:
- Complete required compliance training in a timely manner
- Review Code of Conduct at least annually and promote and enforce CCA's Code of Conduct
- Promote and enforce CCA's compliance program
- Adhere to CCA's Policy & Procedures
- Promptly, in good faith, report any instances of suspected fraud, waste and abuse; suspected privacy and/or security incidents; or any compliance concerns identified
- Ensure confidentiality of member and company proprietary information is maintained
Qualifications
Education & Licensing:
- Associate's degree in nursing with current nurse licensure in good standing in Massachusetts. Bachelor's is desired.
- CPR certification required
Experience (Must Have):
- 5+ years clinical experience
- 5 years experience working in acute or long term care setting
Experience (Nice to Have)
- Home care or care management experience preferred
- Experience working with MassHealth populations preferred
- Experience with care management platform strongly preferred
Knowledge, Skills & Abilities
- Ability to communicate effectively with clinical staff and physician offices
- Good technology skills, including use of electronic health records and Microsoft Excel
- Able to function effectively as part of a team
- Ability to organize and prioritize work independently
- Deep familiarity with medical terminology
- Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.
- Experience with medical records review preferred
- Knowledge of MDS strongly preferred
Language: English. Bilingual is a plus
We are an equal opportunity employer and welcome applications from all qualified individuals.