Top 9 Utilization review nurse Jobs in Reading, Pa

MDS Coordinator - LPN
Confidential —Lancaster, PA
- Full-time
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- Background check
- Nursing
- Anatomy knowledge
- Health insurance
- Dental insurance
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- Full-time
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- Tuition reimbursement
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MDS Coordinator - LPN

Confidential
Lancaster, PA

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Skilled nursing facility experience
Long term care experience
MDS
LPN

Full Job Description

Overview

Full Time, In-Office Position. Remote/Hybrid Work Will Not Be Considered.

We are seeking a dedicated and detail-oriented Licensed Practical Nurse (LPN) to serve as an MDS Coordinator, playing a vital role in ensuring accurate and compliant clinical documentation within our healthcare facility. In this dynamic position, you will lead the comprehensive assessment and coordination of the Minimum Data Set (MDS) process, which is essential for quality patient care, reimbursement, and regulatory compliance. Your expertise will help optimize patient outcomes by ensuring precise data collection, coding, and documentation aligned with industry standards and regulations. This role offers an exciting opportunity to utilize your nursing background and clinical documentation skills in a collaborative environment committed to excellence.

Responsibilities

Lead the MDS assessment process by reviewing patient records, ensuring completeness and accuracy of clinical documentation in accordance with CMS (Centers for Medicare and Medicaid Services) guidelines.
Collaborate with interdisciplinary teams—including nursing, therapy, social work, and medical staff—to gather comprehensive data for each resident or patient.
Ensure compliance with all state healthcare regulations, long-term care regulations, HIPAA (Health Insurance Portability and Accountability Act), and clinical documentation standards.
Utilize EMR/EHR systems such as PointClickCare to document assessments, review medical records, and update electronic health records accurately.
Perform detailed medical coding using CPT (Current Procedural Terminology), ICD-9/10 (International Classification of Diseases), DRG (Diagnosis-Related Group), and ICD coding standards to support proper reimbursement.
Conduct utilization management and review processes to support case management efforts, discharge planning, and ensure appropriate level of care.
Maintain thorough documentation review processes to support clinical documentation improvement initiatives and ensure compliance with Medicare regulations.
Stay current on health regulation policies including long-term care regulations to ensure ongoing compliance across all documentation activities.

Experience

Proven experience as an LPN with a strong background in nursing practice within long-term care.
Demonstrated expertise in medical documentation review, medical coding (CPT, ICD-9/10), and utilization review processes.
Familiarity with EMR/EHR systems such as PointClickCare platforms; proficiency in Microsoft Office is preferred.
Knowledge of CMS regulations related to Medicare reimbursement policies and long-term care requirements.
Experience working in long-term care facilities such as nursing homes or skilled nursing facilities is highly desirable.
Skilled nursing facility background is advantageous for understanding complex patient cases requiring detailed documentation.
Strong understanding of anatomy and physiology principles relevant to accurate clinical assessment and documentation standards.
Ability to interpret medical records accurately while adhering to HIPAA guidelines for patient privacy and confidentiality.

Join us in this impactful role where your expertise directly contributes to delivering exceptional patient care while ensuring our facility remains compliant with all regulatory standards!

EOE

Benefits:

Dental insurance
Health insurance
Paid time off
Vision insurance

License/Certification:

LPN (Required)

Ability to Commute:

Lancaster, PA 17573 (Required)

Work Location: In person

Quick Apply

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utilization review nurse jobs in reading, pa

MDS Coordinator - LPN

Social Worker Ambulatory Care Manager (Full Time/Days)

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