RN MDS Reviewer

Job not on LinkedIn

🔥 0 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $62.7k - $100.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• 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