RAI Director

Overview

Presbyterian Homes & Services is seeking an RAI Director to join our team.  

 

The 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.

 

This position is hybrid, with on-site visits to assigned communities. 

 

Reporting Structure

The RAI Director reports directly to the Director of Care Center Services, supervises MDS nurses and coordinates the resident assessment process with other health professionals.

Responsibilities

Some of the responsibilities of the RAI Director are:

• Hire, train and manage the performance of the MDS Nurses in your assigned region.
• For your assigned region, direct and ensure the development and completion of the resident assessment process with other health professionals consistent with regulations and established clinical best practices. Ensure timely, accurate and complete assessment of the resident’s health and functional status during the entire assessment period
• Ensure that an accurate schedule and assignments of all MDS assessments to include the proper reference dates throughout the resident’s stay is maintained by the assigned MDS Nurse.
• Audit PDPM grouper/MDS end splits, review all expedited appeals and ALJ level appeals. Perform concurrent MDS review to assure appropriate category is achieved through the capture of appropriate clinical information.
• Perform monthly QI/QM review for assigned region and provide recommendations to site administrator/IDT and MDS Nurses.
• Complete triple check for assigned region (Review UB04’s for clinical billing), review ancillary service charges.
• Determine denials/communications at IDT, track residents in 30 day window, monitoring regulatory compliance for completion.
• Participate in the interdisciplinary team process (IDT) to communicate opportunities, facilitate efficient and effective care plan development and management for your assigned region. 
• Specifically communicate (but not limited to):  Medicare/Medicare Advantage admissions, changes to skilled services, PPS scheduled assessment ARDs, significant change in status assessments, PPS unscheduled assessment ARDs, Medicare beneficiary and Medicare Advantage Plan notices.
• Prepare and lead functional work group for your team.
• Maintain knowledge of all MDS based QRP/Quality Measures and work to address 5-star Quality Measures consistent with PHS guidelines.

Qualifications

• Registered nurse with current licensure the State Board of Nursing in state(s) in which he/she practice
• Previous long-term care experience with a working knowledge of the RAI 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's mission and operating philosophies
• Demonstrated ability to read, write, speak and understand the English language to communicate with all customers.

Pay Range

The estimated starting pay range for this role is $81,598 - $101,982 per year. This good faith estimate is based upon PHS’s typical starting pay range for this role. Actual pay range depends upon 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
• Voluntary short-term & long-term disability
• Accident & hospitalization coverage
• Education assistance programs

 

All employees:

• Accrue PTO (Paid time off)
• Same-day pay
• Employee assistance program (EAP)
• College partnership educational discounts
• Access to Learn to Live Resources

About PHS

Presbyterian Homes & Services (PHS), based in St. Paul, Minnesota, is a nonprofit, faith-based organization providing a broad array of high-quality housing choices, care and services options for older adults. Some 8,000 employees serve more than 41,800 older adults through 60 PHS-affiliated senior living communities in Minnesota, Iowa and Wisconsin, and through Optage® home and community services. PHS is also co-owner of Genevive, the largest geriatric primary care practice in Minnesota, providing comprehensive care for more than 15,500 older adults. Established in 1955, PHS has earned the reputation as an innovative leader dedicated to promoting independence, purposeful living and the overall well-being for those they serve. Today, PHS is one of the largest nonprofit providers of senior housing and services in the nation.

 

 

PHS is an EEO/AA employer. All applicants will receive consideration for employment regardless of their race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status, or status with regard to public assistance.