Consultant Jobs in Providence, RI

Job Summary

We are seeking a dynamic and experienced Regional Director of MDS (Minimum Data Set) to lead and oversee the comprehensive management of MDS processes across multiple healthcare facilities. In this pivotal role, you will ensure the accuracy, compliance, and timeliness of resident assessments, driving quality patient care and regulatory adherence. Your leadership will foster a culture of excellence in clinical documentation, utilization management, and interdisciplinary collaboration, ultimately enhancing operational efficiency and resident outcomes. This position offers an exciting opportunity to influence long-term care quality standards on a regional scale while working with a dedicated team committed to compassionate, patient-centered care.

Duties

• Lead and coordinate the MDS process across all assigned facilities, ensuring timely completion and accuracy of assessments in accordance with CMS (Centers for Medicare & Medicaid Services) regulations and state healthcare policies.
• Oversee clinical documentation improvement initiatives to optimize reimbursement and compliance with HIPAA (Health Insurance Portability and Accountability Act) standards.
• Collaborate with interdisciplinary teams including nursing, medical staff, case management, and health information management to facilitate effective discharge planning, care coordination, and patient care strategies.
• Monitor and review medical records, medical documentation, coding (ICD-10), and clinical documentation standards to ensure adherence to regulatory requirements such as NCQA (National Committee for Quality Assurance) standards.
• Manage utilization review and utilization management protocols such as Triple Check to promote appropriate resource use while maintaining high-quality care standards.
• Provide training and mentorship to MDS nurses
• Use PCC and other platforms to improve coding accuracy and workflow efficiency.
• Stay current with evolving healthcare regulations including Medicare policies, long-term care regulations, and Medicaid policies to ensure ongoing compliance across all facilities.

Qualifications

• Proven expertise in MDS processes with familiarity in ICD coding , RI CMI management, and case management practices.
• In-depth knowledge of CMS guidelines, HIPAA regulations, and state healthcare laws, and regulations
• Demonstrated leadership skills with experience managing multidisciplinary teams across multiple facilities or regions.
• Strong assessments and knowledge of the RAI, MBPM, and QUality Measure manuals
• Excellent communication skills
• RN licensure preffered ( will consider and LPN with the right qualifications and skills) and RAC-CT preferred.

Join us in shaping the future of long-term care by leading regional efforts that prioritize excellence in patient outcomes and coding practices!

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• MDS 3.0: 3 years (Preferred)

License/Certification:

• RI nursing (RN/LPN) license (Preferred)

Work Location: Hybrid remote in Providence, RI 02912