MDS Care Management Supervisor, LPN, Presence Villa Francisican, Joliet, IL:
Presence Health

Presence Health
Joliet Illinois

Requisition ID: 47493

Location: PLC Villa Franciscan

Location Address:
210 North Springfield Avenue, Joliet, IL  60435 United States (US)


Daily Hours: 8
Standard Hours: 40
Employment Status: Full-time 
Employment Type: Regular 
Shift: Day



The Supervisor, MDS Care Management – Licensed Practical Nurse is responsible for the accurate and timely completion of all Medicare/Medicaid case-mix documents in order to assure appropriate reimbursement for services provided within the skilled nursing facility.  The Supervisor conducts concurrent MDS review to assure the achievement of maximum allowable Resource Utilization Group (RUG) categories. This position supervises the entire process and tracking of Minimum Data Set (MDS)/Prospective Payment System (PPS) documentation and transmission. 



  • Tracks Medicare residents to determine continued and appropriate Medicare eligibility and benefit period by predicting subsequent Resource Utilization Group (RUG) categories.
  • Performs concurrent Minimum Data Set (MDS) review to ensure appropriate RUGs category is achieved through the capture of appropriate clinical information. Identifies opportunities to enhance reimbursement. Ensures timely, accurate and complete assessment of the Resident’s health and functional status during the entire assessment period.
  • Participates in the interdisciplinary team process to communicate opportunities, facilitate efficient and effective care plan development and management. Communicates with care team regarding practitioner’s orders, care plans, and changes in condition.
  • Collaborates with team to review Case mix reports and identify RUGs categorization.
  • Communicates with the Facility Administrator and the interdisciplinary team regarding any changes in MDS.
  • Conducts quality improvement to evaluate the clinical performance, efficacy, and patient outcomes as related to the patient care provided and the course of action required. Organizes Medicare/Utilization review meetings.
  • Coordinates care plan conferences for Medicare/Medicaid residents
  • Assesses and evaluates the outcomes of the MDS process to determine additional training, education, and monitoring needs. Identifies areas of educational need to the facility administrator and appropriate divisional personnel.
  • Maintains established department/facility policies, procedures, directives, and quality assurance standards appropriate to this position.
  • Conducts regular audits of MDS process. Audits medical record documentation to validate that the documentation supports the MDS coding. Reviews initial and final validation and error reports.
  • Assists in the requests from government agencies regarding payment of services (denials, demand bills) etc.
  • Maintains a current and comprehensive knowledge of MDS and Medicare (PPS) reimbursement. Integrates nursing, physician, rehabilitation and other ancillary services to ensure appropriate reimbursement.
  • Other duties may be assigned.



Directly supervises employee(s). Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.



Education and/or Experience                                                              

  • Graduate from an accredited nursing program.
  • Three years of clinical experience in the area of MDS/PPS preferred.


Computer Skills                                                          

  • Knowledge of Microsoft Office software.


Certificates, Licenses, Registrations

  • Current LPN licensure in the state of Illinois required.
  • Certification as a Resident Assessment Coordinator (RAC-CT) through the American Association of Nurse Assessment Managers (AANAC) or as a Certified Registered Nurse Assessment Coordinator (CRNAC) through the National Association of Sub Acute and Post-Acute Care (NASPAC) preferred.                       


Business Unit: PLC Senior Services


EOE of Minorities/Females/Vets/Disability

Basic Qualifications