Covenant Care - Resource Center

  • Quality Assurance and Case Manager Nurse

    Job Locations US-CA-Gilroy
    Job ID
    2019-13127
    Job Code
    161D
    Facility
    Gilroy Healthcare and Rehabilitation Center
    Category
    Nursing
    Type
    Regular Full-Time
    Shift
    Day
  • Overview

     

    POSITION SUMMARY:  The primary purpose of this position is to mange the MDS function and processes to : (1) maximize clinical outcomes for patients and residents, and (2)ensure timely, accurate and complete clinical and support documentation to enable the facility to be fully reimbursed by government payer sources for all services provided, by accomplishing the specific business goals.

     

    This position also oversees the clinical planning and case management for skilled short term residents. Duties will include timley communication with patient insurances, resolution of care issues, and preparation for patient discharges.

     


     

     KEY JOB FUNCTION:

    • Coordinates the completion of assessments per the OBRA schedule and PPS schedule as appropriate.
    • Conducts CAA's analysis to determine which problems require consideration for developing care plan interventions.
    • Timely communication of findings and recommendations to Director of Nursing and Executive Director.
    • Assist in developing a timely, accurate, and comprehensive care plan for each resident that is individualized with measurable objectives.
    • Complete timely transmission of MDS assessments per company standards.
    • Help plan the patients care through weekly meetings with physicians
    • Send needed documentation to insurance companies
    • Prepare patients for discharge while preparing equipment and needed services and coordinating with patient's physician.

    Minimum Requirements

    • Must posses a current, unencumbered, active license as a LPN/LVN or RN in the State in which you are employed.
    • Must meet the general health requirements set forth by the policies of the facility or department which may include a medical and physical examination.

    Preferred Requirements

    • Preferred one year experience in Long-Term Care.
    • Preferred at least one year experience in MDS.

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