Job Description

Overview:

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

The Lead RAI Director is a critical role to support the RAI Directors and functions within the department. RAI Directors are 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, and the Lead RAI Director will assist with training and mentoring RAI Directors, provide critical support for PHS expansion, and improve quality measures and reimbursements for sites.

This position supports multiple PHS locations; travel may be required including day and occasional overnight trips.

Reporting Structure

The Lead RAI Director reports directly to the Director of Care Center Clinical Service.
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 Maintain an accurate schedule and assignments of all MDS assessments to include the proper reference dates throughout the resident's stay. Audit RUG grouper/MDS end splits, review all expedited appeals and ALJ level appeals. Perform concurrent MDS review to assure appropriate RUGs category is achieved through the capture of appropriate clinical information. Perform monthly QI/QM review for assigned region and provide recommendations to 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.

In conjunction with the essential functions of the RAI Director, the Lead RAI Director responsibilities

include:Assist with training, mentoring and orientation of other RAI Directors, as requested. 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 Measures and Reimbursement for sites by directing the other RAI Directors on the approved plan.
Qualifications:
Registered nurse with current licensure the State Board of Nursing in states in which PHS serves. 5-10 years as an RAI Director or similar position within the SNF setting. 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 $72,738 - $90,917 per year. 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 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:

Based in St. Paul, Minnesota-Presbyterian Homes & Services (PHS) is a nonprofit, faith-based organization providing a broad array of high-quality housing choices, care options and services for older adults. There are over 7,500 team members like you at PHS, serving more than 26,000 older adults through 60+ PHS-affiliated senior living communities in Minnesota, Iowa and Wisconsin, and through Optage and other community services. PHS is also co-owner of Genevive, the largest geriatric primary care practice in MN, providing comprehensive care for over 15,000 older adults.




An Innovative Leader: Established in 1955, PHS has earned the reputation as an Innovative Leader dedicated to promoting independence, purposeful living, and overall well-being. PHS is now one of the largest nonprofit senior housing and services providers in the US.



Our strong focus on our employees, means we are committed to an environment where you are valued and empowered to make a difference. With a strong commitment to team growth from within, roughly 80% of leadership roles are filled through the development of people like you. To learn more about PHS culture, benefits and team development, we invite you to visit the "Careers" section of our website.



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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.