Clinical data coordinator jobs in Los Angeles, California - Page 3Create job alerts

Job Description Pay Range: $55.00 - $60.00/hour JOB CULTURE The Masonic Homes of California are committed to a culture of Leadership. Our culture is to provide superior service to members, residents and staff through a sound and progressive model of service and care which aligns our mission, vision and operations. We demonstrate excellence in core services and place value on high quality job performance, professional development, effective time management, budget management, workplace safety and resident/employee satisfaction. We are dedicated to disciplined innovation and continuous quality improvement – we are a learning company. We are committed to sharing our knowledge and being an organization that attracts the best and brightest talent. We are team-oriented, caring and honest. JOB SUMMARY The Minimum Data Set (MDS) Coordinator is responsible for the MDS assessment process completion, care planning process, and scheduling of MDS assessments. The MDS Coordinator assures maximum reimbursement by: determining payment coverage of each resident from admission to discharge; and by strategically setting Assessment Reference Dates (ARD’s) for the MDS in collaboration with therapy services within the Omnibus Budget Reconciliation Act (OBRA) requirements. This position is responsible for determining Resource Utilization Group (RUG) levels and assisting with admission assessment processes. This position requires on-going education related to rules and regulations regarding MDS process and reimbursement. JOB RESPONSIBILITIES • Administrative functions, • May be involved in the pre-admission assessment in collaboration with the DON, Admissions Coordinator and HIM to determine coverage level for Skilled Nursing Facility (SNF) stay., • Meets routinely and as indicated with the business office regarding billing requirements., • Leads PPS meeting with therapy and unit coordinators to ensure goals are accomplished, review resident's progress, determine reimbursement days used, days left to be used, and overall plan of care., • Coordinates with interdisciplinary team (IDT) dates of discontinuation of qualified Medicare coverage benefits for stay and date of termination notification issued to resident and/or responsible party., • Tracks to ensure necessary certifications/re-certifications are completed and obtained in a timely manner., • Monitors regulatory compliance for completion of MDS/Resident Assessment Instrument (RAI) process., • Attends morning IDT meeting, care plan, and discharge meetings as indicated., • Resident Assessment Instrument (RAI) process, • MDS submission/transmission, • Quality assurance, • Other functions, • Supports Nursing staff in their absence., • Attends ongoing educational programs relative to Medicare, Prospective Payment System (PPS), MDS/RAI process, reimbursement changes, and Centers for Medicare and Medicaid Services (CMS) regulatory revisions., • Provides educational training relating to Medicare, PPS, and MDS/RAI process to staff as requested., • Provide direct nursing care as necessary. Requirements SKILLS, ABILITIES AND EXPERIENCE • Knowledgeable of the theory, methods, and techniques of nursing., • Knowledge of Medicare and Medical reimbursement principles and methods of implementation., • Knowledge of principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions., • Ability to maintain composure and cope with stress and frustration., • Knowledge in computer skills with competency in computer applications., • Ability to use office equipment and programs including but not limited to: email, telephone, computer, photocopier, printer, fax and Microsoft Office programs, • Ability to communicate clearly in oral and written English., • Ability to maintain regular, consistent and reliable attendance, • Graduate of an accredited school of nursing, • Current CA RN license, • At least 3 years of clinical experience in long-term care nursing with 1 year in a management/administrative or supervisory role preferred, • Prior RNAC experience required, • Experience in Minimum Data Set/Resident Assessment Instrument/Prospective Payment System in a Skilled Nursing Facility, • Resident Assessment Instrument certification preferred; must be certified within six months of the date of hire, • Experience with and knowledge of Medicare rules, regulations and documentation requirements, • Computer and typing proficiency At the Masonic Homes you will have the opportunity to combine your passion for helping people and high ethical standards with the opportunities to advance your career. In return for your skills and passion, we offer: • A work environment focused on teamwork and support for excellent care, • Excellent health, wage replacement and other benefits for you and your family’s well-being, • A generous contribution to a 401K plan whether or not you participate, and an additional contribution from the company when you participate in the plan, • Investment in your growth through Tuition Reimbursement

Job DescriptionQUALIFICATIONS: Minimum qualifications include an RN with a BA/BS degree in nursing from an accredited college/university and a California Public Health Certification or a master’s degree from an accredited college/university in socia1 work, human services, public health, public administration, or related field along with a valid California Driver’s License are required. Must have five years of related experience and/or training in the areas of federal and state benefit programs; developmental disabilities; knowledge of ICD9-CM diagnostic criteria and other medical conditions. ESSENTIAL DUTIES AND RESPONSIBILITIES: Under the direction of the Director of Clinical Services, the Medicaid Waiver Manager’s position will act as SCLARC’s Federal Revenue Coordinator, enable the State to receive federal funding and ensure SCLARC’s program compliance with the state and federal laws and regulations. The candidate is responsible for supervising the Medicaid Waiver Specialist staff and the Medicaid Waiver nurse consultants. Responsible for coordinating all state and federal benefit programs for SCLARC consumers, such as Medicaid Waiver, PRUCOL, Early and Periodic Screening Diagnostic Treatment (EPSDT), Institutional Deeming, and Nursing Home Reform. Assists with the completion of annual HCBS waiver enrollment, recertification, and termination of Medicaid waiver eligibility. Ensures CDER data integrity, reviews and determines billable services, choice statements and reconciles Medicaid waiver data. Maintains records in accordance with applicable federal requirements for accuracy and completeness, reviews case records for eligibility to the DDS Medicaid C Waiver, SDP Waiver, and the Institutional deeming program. Responsible for developing and participating in training sessions on HCBS waiver policies and procedures. Participates in ARCA Federal Revenue Coordinator Committee meetings, Regional Center and other community meetings. Provide staff training and technical assistance to service providers and work with case management staff to ensure timely certifications and recertification of federal programs for consumers. Must have the ability to interpret regulations and mandates as well as write policies and procedures. Ongoing tasks and training related to Target Case Management (TCM). Organizes, prepares and is the lead person for DDS monitoring reviews. Must have the ability to maintain a working relationship with the Department of Developmental Services. Qualified candidates must possess excellent interpersonal skills and be able to work with interdisciplinary and multidisciplinary clinical and case management teams. Good written and verbal communication skills as well as the ability to compile and analyze statistical data. Must possess proficient computer skills with knowledge of Microsoft Word, PowerPoint, and Excel.