Director Medicare Rac Audit Jobs in Rye, NY (NOW HIRING)

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Active - Regular full-time RYE, NY, US

30+ days ago Requisition ID: 2099

Director of Resident AssessmentThe Osborn – Rye, NY

Status: Full-Time
Salary Range: $115,000 – $137,000
Schedule: Monday–Friday, 8:30 AM – 4:30 PM
Department: Nursing / Resident Assessment
Reports To: Pavilion Administrator & COO

About The Osborn

The Osborn is a mission‑driven senior living organization founded in 1908 and renowned for its clinical excellence, resident-centered care, and interdisciplinary collaboration. The community is dedicated to providing a compassionate and supportive environment while upholding the highest standards of care.

Position Summary

The Director of Resident Assessment is responsible for overseeing all resident admission assessments to determine clinical and technical eligibility for Medicare coverage. The role ensures all documentation related to Medicare requirements is completed accurately and timely. As a key leader in the Pavilion, this position works closely with the Pavilion Administrator, Director of Nursing Services, and interdisciplinary teams to support organizational goals and uphold quality standards.

Essential Job Functions

• Complete Full and Comprehensive MDS 3.0 assessments for all Medicare Part A residents according to required schedules.
• Communicate Medicare‑related information, including RUG groups and coverage status, to the Finance Department and interdisciplinary team.
• Lead and participate in special projects as assigned.
• Conduct staff education on assigned topics related to nursing and regulatory requirements.
• Evaluate and report Quality Indicators and Quality Measures to administration.
• Screen all admissions and readmissions for Medicare A eligibility.
• Stay current with MDS reporting changes and provide staff training as needed.
• Submit MDS 2.0 data to appropriate regulatory agencies.
• Participate in Daily Report meetings and coordinate Short‑Term Rehabilitation meetings.
• Assist with resident care and documentation when necessary.
• Determine daily whether residents meet Skilled Care Guidelines for Medicare coverage.
• Communicate discontinuation of Medicare coverage when appropriate.
• Coordinate scheduling of Medicare MDS 3.0 assessments per state and federal requirements.
• Collaborate with the Rehabilitation Department regarding restorative therapy documentation and Medicare requirements.
• Oversee the clinical components of the Quick Care computer program and assist with related staff training.

Knowledge, Skills & Abilities

• Comprehensive knowledge of Medicare Skilled Care Guidelines, MDS 3.0 regulations, PDPM, Quality Indicators, and Quality Measures.
• Excellent verbal and written communication skills.
• Strong leadership abilities, including meeting facilitation and team coordination.
• Current Registered Nurse (RN) license in the State of New York.
• Resident Assessment Coordinator-Certified (RAC-CT)
• Two years of management experience preferred.
• Extensive knowledge of gerontological nursing.
• Ability to make independent decisions and model professionalism.
• Ability to work collaboratively with interdisciplinary teams.

Physical & Sensory Requirements

• Ability to walk throughout the building and stand, sit, and bend for extended periods (0.5–7.5 hours).
• Ability to lift and carry 10–25 lbs for short distances.
• Adequate vision and hearing (with or without prosthetics).
• Ability to operate basic office equipment including PC, fax machine, and copier.
• Ability to manage the mental and emotional stress associated with the role.

Working Conditions

• Frequent interruptions during daily workflow.
• Regular interaction with residents, staff, families, and external personnel.
• Exposure to infectious waste, hazardous chemicals, odors, and environmental contaminants.
• May be required to work beyond scheduled hours, including weekends, holidays, or emergency call‑backs.
• Participation in continuing education and community health activities expected.

Accountability

The Director of Resident Assessment is responsible for completing all essential job functions accurately and on schedule. Performance in this role directly impacts resident care quality and compliance and may be reflected in performance evaluations.