Corporate Minimum Data Set (MDS) Director - Concierge Health Group

Overview We are seeking a highly experienced and dynamic Corporate MDS (Minimum Data Set) Director to lead our team MDS coordinators as well as lead our clinical documentation and compliance initiatives within the Concierge Health Group. Typically a Registered Nurse (RN) - manages The Resident Assessment Instrument (RAI) process, assessing patient health, designing care plans, and ensuring regulatory compliance for Medicare/Medicaid reimbursement in long-term. This pivotal role involves overseeing the development, implementation, and management of comprehensive MDS processes to ensure accurate patient assessments, regulatory adherence, and optimal reimbursement strategies. The ideal candidate will possess a strong background in managed care, acute and inpatient care settings, and extensive expertise in medical coding, documentation review, and healthcare information systems as well as oversee team members. Join us to drive excellence in clinical management and elevate patient care standards across diverse healthcare environments. Responsibilities Lead the design, execution, and continuous improvement of MDS assessment processes aligned with industry standards such as NCQA and CMS regulations. Oversee clinical documentation improvement initiatives to enhance accuracy and completeness of medical records, ensuring compliance with HIPAA and other privacy regulations. Collaborate with multidisciplinary teams including nursing, case management, utilization review, and coding specialists to optimize patient assessments and reimbursement outcomes. Supervise daily staff operations. Manage the integration of EMR (Electronic Medical Record) systems such as Cerner, Epic, Athenahealth, eClinicalWorks, ensuring seamless data flow for inpatient, outpatient, hospice, home care, and skilled nursing facilities. Conduct regular audits of medical documentation to verify adherence to coding standards including

ICD-10/ICD-9/ICD

coding, CPT coding, DRG assignment, and physiology-based documentation practices. Provide leadership in discharge planning processes for complex cases involving

ICU, PICU

(Pediatric ICU), Level I/II trauma centers, and emergency medicine settings. Ensure compliance with Medicare requirements and other payer-specific guidelines related to utilization management and review procedures. Develop training programs for clinical staff on documentation best practices, medical terminology, anatomy knowledge, and health information management protocols. Skills Extensive experience with EMR/EHR systems such as Cerner, Epic (including MyChart), Athenahealth, eClinicalWorks; proficiency in navigating complex health IT platforms. Strong knowledge of managed care principles including Medicare regulations, NCQA standards, utilization review/management protocols. Critical care experience in

ICU/PICU

settings; hospital experience at Level I or Level II trauma centers preferred. In-depth understanding of medical coding including

ICD-10/ICD-9/ICD

coding systems; CPT coding; DRG assignment; medical records review. Familiarity with clinical documentation improvement strategies to enhance case management accuracy across inpatient and outpatient environments. Knowledge of physiology, anatomy, nursing practices, discharge planning procedures, hospice care protocols and emergency medicine workflows. Ability to interpret complex medical records while maintaining HIPAA compliance; strong attention to detail in documentation review processes. Excellent leadership skills with the ability to manage cross-functional teams involved in health information management and case management activities. Join our team to lead innovative clinical data strategies that improve patient outcomes while ensuring regulatory excellence!

Pay:

$120,000.00 - $150,000.00 per year

Benefits:

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

Work Location:

In person