Lead RAI Director

Overview

PHS Management division is seeking a full time Lead RAI Director to join its team.  

 

This position is responsible for the coordination of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payer program requirements for assigned regional of Care Centers. This position is also responsible for ensuring assessments accurately reflect the physical, mental and psychosocial status of each resident; ensures appropriate documentation to report and support services provided and assessment accuracy; communicating effectively with other members of the interdisciplinary team.and managing the activities and performance of the MDS Nurses in assigned region.  

 

REPORTING STRUCTUREThe Lead RAI Director reports directly to the Direct of Care Center Clinical Services or designee. The Lead RAI Director supervises MDS nurses and coordinates the resident assessment process with other health professionals.

Responsibilities

The Lead RAI Director is a regional role that is responsible for coordinating and overseeing the development and completion of the resident assessment process consistent with regulations and established clinical best practices across PHS designated care centers.

  

In conjunction with the essential functions of the RAI Director, this addendum displays the areas of focus and responsibilities of the Lead RAI Director.

 

• Assist with training, mentoring and orientation of other RAI Directors, as requested.
• Assist with coverage for open RAI positions, or when RAI directors are on leave or in need of additional support.
• Observe and provide feedback to Director of Care Center on possibilities for site improvements.
• Support in the startup for new openings of PHS buildings or acquisitions.
• Work collaboratively with the Director of Care Center and the VP of Clinical Services to improve the overall Quality

 

Other specific areas of responsibility include but are not limited to:

• Scheduling of PPS and OBRA MDS assessments for assigned region

• Hiring, training, leading and managing MDS nurses

• Auditing RUG grouper/MDS end splits
• Reviewing all expedited appeals and ALJ level appeals
• Monthly QI/QM review for assigned region and provide recommendations to IDT and MDS
• Participating in Interdisciplinary Team meetings (IDT) for assigned region
• Completing Triple check for assigned region (Review UB04’s for clinical billing, reviews ancillary service charges)

• Determination of denials/ communicate at IDT

• Site specific education

• Key measure management

Qualifications

• Registered nurse with current licensure from the State Board of Nursing in the state(s) in which he/she practices.

• 5-10 years as an RAI Director or similar position within the SNF setting.

  Previous long-term care experience with a working knowledge of the MDS process. 
• Experience with MDS completion, reimbursement, clinical resource utilization and/or case management.
• Ability to work flexible work hours to support business requirements.
• Competency with standard office software applications as well as software applications related to MDS/RAI processes.
• High initiative and ability to efficiently and effectively lead interdisciplinary teams and coordinate and manage RAI process.
• Demonstrated compatibility with PHS' mission and operating philosophies.
• Demonstrated ability to read, write, speak and understand the English language to communicate with all customers.
• Travel Requirements:
  • This role may require regular travel to support sites with serious reimbursement/Quality Measure concerns along with the sites RAI Director.
  • Travel may include day trips, and in rare cases overnight trips.

Pay Range

The estimated starting pay range for this role is $91,784-$112,180 This good faith estimate is based upon PHS’s typical starting pay range for this role. Actual pay range depends on many factors including each individual employee’s qualifications and market conditions and is subject to change.

Benefits

Full-time benefits-eligible employment begins at a minimum of 30 hours per week:

• Health, and dental, including applicable HSA & FSA
• Employer Contribution to HSA for eligible Health Plans
• Life insurance (AD&D)
• Retirement, with eligibility for an employer match
• Holiday pay and extended sick

 

Full and Part-time benefits-eligible employment working between 20-29 hours per week:

• Vision insurance