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LR
Lawrence Rehabilitation and Healthcare
RNAC
Career Insights for Clinical Auditor / Utilization Reviewer
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Based on New Jersey data
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What they do
A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.
$98,199 / year median in New Jersey
-7% projected decline
Job Description
RNAC Lawrence Rehabilitation and Healthcare
- 4.3 Township of Lawrence, NJ Job Details Full-time $105,000
- $120,000 a year 4 hours ago Benefits Dental insurance Tuition reimbursement Employee assistance program Vision insurance 401(k) matching Life insurance Referral program Qualifications Long-term care regulations Medicare RN License Long-term care facility experience CMS regulatory compliance Medicare regulations Centers for Medicare and Medicaid Services (CMS) Medicaid regulations Medicaid Health status assessment Healthcare reimbursement methods Full Job Description Join our team at Lawrence Rehabilitation and Healthcare Center as an RNAC.
- 120,000 per year (all-inclusive) At Lawrence Rehabilitation and Healthcare Center, we believe that accurate clinical documentation and assessment are essential to delivering high-quality, compliant, and person-centered care.
RNAC:
Ensure timely and accurate completion of all MDS assessments in accordance with regulatory requirements and established deadlines. Verify compliance with federal, state, and facility regulations related to MDS documentation and submission. Supervise MDS data entry, validation, and transmission processes to ensure accuracy and timeliness. Identify, investigate, and resolve data discrepancies and validation issues. Prepare and present MDS-related reports and updates to the Director of Nursing (DON) and leadership team. Provide feedback to clinical teams and address operational concerns related to documentation and care planning. Participate in facility surveys, audits, and regulatory reviews, providing required documentation and support. Assist with audit responses and maintain ongoing compliance with Medicare and Medicaid requirements. Stay current on changes to Medicare, Medicaid, and RAI/MDS regulations and guidelines. Support and contribute to MDS-related quality improvement and performance initiatives. Collaborate with interdisciplinary teams to ensure accurate representation of resident care needs. Qualifications forRNAC:
Graduate of an accredited School of Nursing (RN, BSN, or LPN). Current, active RN license required. Minimum of three (3) years of clinical experience in a long-term care setting. Prior MDS/RAI experience required. Strong clinical assessment skills with attention to detail and accuracy. Working knowledge of Medicare and Medicaid regulations and reimbursement systems. Our Core Values in Action Passion- Ensuring residents are accurately assessed so they receive the care and resources they need to thrive. Respect
- Upholding integrity, accuracy, and confidentiality in all resident documentation and interactions with care teams. Excellence
- Delivering precise, compliant, and high-quality MDS processes that support optimal outcomes and regulatory success.