We are a senior living facility dedicated to fostering health, happiness, and independence for our residents in a nurturing, home-like environment. We prioritize the satisfaction and well-being of our team members, recognizing that exceptional patient care begins with a supported and empowered staff. Our commitment extends beyond meeting industry standards—we strive to innovate and equip our professionals with cutting-edge tools, safe equipment, and a collaborative culture that values respect, empathy, and appreciation. Located in a serene community in Illinois, our facility offers skilled nursing, independent living, and outpatient therapy, all underpinned by a patient-centric philosophy and a passion for excellence.

The MDS/Care Plan Coordinator, RN, plays a pivotal role in ensuring the integrity of the facility’s Resident Assessment Instrument (RAI) and Medicare processes. This position is responsible for managing the Minimum Data Set (MDS) assessments, care planning, and Medicare documentation to ensure compliance with federal and state regulations. The Coordinator ensures that residents receiving Medicare services qualify for coverage, that skilled nursing care is delivered consistently, and that all documentation supports ongoing reimbursement. By collaborating with the interdisciplinary team, families, and residents, the Coordinator fosters individualized care plans that enhance resident outcomes while maintaining accurate billing and regulatory adherence.

Essential Duties and Responsibilities

• Physician Certifications: Obtain and maintain timely physician certifications for each Medicare resident to support coverage eligibility.
• MDS and Care Plan Coordination: Prepare and coordinate MDS assessments and care plans in accordance with regulatory requirements, ensuring timely and accurate completion for quarterly, annual, admission, and significant change assessments.
• Care Plan Meetings: Schedule and facilitate open care plan reviews, inviting families and/or residents in writing at least two weeks prior to meetings. Offer flexible scheduling to accommodate resident and family needs, and assist residents in attending meetings.
• Medicare Documentation: Ensure daily Medicare documentation is complete, appropriate, and aligns with coverage guidelines. Verify documentation supports skilled services and communicate with case managers to confirm reimbursement levels and primary diagnosis authorization.
• Interdisciplinary Collaboration: Monitor and guide the interdisciplinary team to complete RAI-required interviews within specified timeframes. Facilitate weekly Medicare and Case Mix Index (CMI) meetings to align team efforts.
• Benefit Tracking and Billing: Track Medicare resident benefit days, validate daily Medicare census, and coordinate with the Business Office Manager to ensure accurate billing.
• Communication: Partner with the Social Service Director to inform responsible parties or residents of Medicare coverage status, including continuation or termination.
• Reimbursement Support: Assist in identifying and obtaining documentation for reimbursement review requests within established timelines.
• Quality Assurance: Review quality measures, audit MDS coding for accuracy, and ensure Medicare coverage adheres to time limits set by guidelines.
• Medicaid Documentation: Participate in evaluating documentation required for Medicaid reimbursement.
• Regulatory Compliance: Stay updated on RAI manual changes and ensure assessments are transmitted to the state repository per regulatory guidelines. Receive validation reports, correct errors, and resubmit as needed.
• Technology Utilization: Use provided software to review and manage alerts related to MDS and care planning processes.
• Additional Duties: Perform other tasks as assigned to support the facility’s operations and resident care.

Qualifications

• Licensure: Active Registered Nurse (RN) license in the state of Illinois, in good standing.
• Certification: Current Basic Life Support (BLS) certification.
• Education: Associate’s or Bachelor’s degree in Nursing from an accredited program.
• Experience: Minimum of 2 years of experience in skilled nursing, long-term care, or a related healthcare setting, with at least 1 year of experience in MDS coordination or care planning preferred.
• Regulatory Knowledge: Strong understanding of RAI processes, Medicare/Medicaid regulations, and PPS (Prospective Payment System) requirements.
• Technical Skills: Proficiency in MDS 3.0 software, electronic health records (EHR), and Microsoft Office applications.
• Interpersonal Skills: Excellent communication and collaboration skills to work effectively with interdisciplinary teams, residents, families, and external stakeholders.
• Organizational Skills: Ability to manage multiple priorities, maintain accurate records, and meet strict deadlines in a fast-paced environment.
• Physical Demands: Ability to stand, walk, and occasionally lift up to 50 pounds. Must have close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. Capable of using a computer and phone for extended periods.
• Environmental Adaptability: Comfortable working in an environment with occasional exposure to blood, body fluids, fumes, airborne particles, or toxic chemicals, and moderate noise levels.
• Accommodations: Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Compensation and Benefits

• Salary: Competitive salary commensurate with experience, ranging from $85,000 to $95,000 annually, based on qualifications and market standards.
• Benefits:
  • Comprehensive medical, dental, and vision insurance plans.
  • Additional voluntary benefits, including life insurance and disability coverage.
  • 401(k) retirement plan with company match.
  • Generous paid leave policy, including vacation, sick leave, and holidays.
  • Free uniforms provided after hire.
  • Access to Daily Pay, allowing employees to access earned wages before payday.
  • Newly renovated breakrooms with fully stocked beverages.
  • Monthly employee appreciation events and celebrations to foster a positive work culture.
• Work Environment: Supportive and collaborative team culture, access to state-of-the-art equipment, and opportunities for professional development through ongoing training on RAI updates and regulatory changes.

Physical Demands

The MDS/Care Plan Coordinator must be able to communicate effectively in English via phone, in writing, and verbally with staff, families, and external stakeholders. The role requires frequent standing and walking, occasional sitting, and the use of hands for handling, reaching, and typing. The employee must occasionally lift and/or move up to 50 pounds and possess specific vision abilities, including close and distance vision, peripheral vision, depth perception, and focus adjustment. Extended use of computers and phones is required. The employee may be exposed to blood, body fluids, fumes, airborne particles, or toxic chemicals, with a moderate noise level in the work environment. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.