PruittHealth Case Mix Coordinator RN HCC in Athens, Georgia

Case Mix Coordinator RN HCC



Responsible for coordinating assessments for each resident including Resident Assessment Instrument (RAI), RAPS and Care Plan. This includes all admission, quarterly, annual and significant change assessments as well as any required Medicare assessment. Responsibilities include maintaining accurate and timely assessments, meeting all automation requirements as defined by the regulations, facilitating a functioning interdisciplinary team, accurate reporting of Resource Utilization Groups (RUGs) to all departments, maintaining roster and census reports and monitoring of all reports generated by this department.


  1. Facilitates communication between nursing center departments and patient/family members to provide an effective assessment/care plan process.

  2. Establishes open lines of communication with consultants. Have effective interviewing skills for the purpose of collecting information from patients, families, and staff members.

  3. Conduct/coordinate patient (or family) interviews for assessment purposes.

  4. Evaluates each patient’s condition and medical data to determine special needs, or the need to amend the admission assessment.

  5. Has a comprehensive understanding of nursing resource material and understands how to incorporate such information into care plans [i.e., nursing journal articles that relate to specific patient care topics (bowel& bladder retraining, restraint assessment & use, fall assessments, skin assessments, etc.)]

  6. Establishes open lines of communication with interdisciplinary team members in order to provide a comprehensive and holistic patient care plan.

  7. Maintains schedule of assessment/care plan meetings. Coordinate schedule with nursing center staff and others (family, therapists’ etc.) to provide for appropriate participation.

  8. Ensures care is provided in accordance with patient’s wishes. Coordinate the development of a care plan (preliminary and comprehensive) for each patent that identifies problems/needs, appropriate interventions, measurable goals, and assign responsibilities for delivery of care.

  9. Provides that patient assessment and care plans are completed in a timeframe that is in accordance with current regulations.

  10. Facilitates education to inform associates of the patient’s care plan prior to administering care.

  11. Coordinates the review of each assessment/care plan for accuracy (including timeliness appropriate signatures and dates etc.)

  12. Signs and dates each assessment to certify its completion.

  13. Monitors the RAI process for accuracy according to the RAI guidelines and other accepted standards.

  14. Educates the interdisciplinary team and other staff members as needed in the RAI process.

  15. Conducts physical assessment of patient to provide accurate RAI process.

  16. Assesses patient needs and make recommendation for skilled rehabilitative services as well as maintenance therapy services.

  17. Conducts patient care conferences. May be required to direct and implement nursing service educational programs in reference to patient assessment and care.

  18. May be required to meet with all shifts for the purposes of planning, coordinating, and implementing patient care.

  19. Assists in compliance with Federal, State, and Local regulations in relation to scheduling, performing, and implementing patient care plans.

  20. May be required to make management reports and participate in special assignments.

  21. Complies with specific time limitations in terms of scheduling and planning patient care.



Nursing Degree from an accredited college or university, or is a graduate of an accredited/approved RN program.


A minimum of one (1) year of experience as a supervisor in a hospital, long-term care facility, or other related health care center.


Current, active and unrestricted Registered Nurse (RN) licensure in state of practice.

ADDITIONAL QUALIFICATIONS: (Preferred qualifications)

Nursing service administration experience and RAI experience preferred


Job Nursing

Primary Location Georgia-Athens

Schedule Full-time

Shift 1st Shift

Job Posting Nov 5, 2018, 1:43:23 PM

Req ID: 1806741

PruittHealth is an Equal Employment Opportunity employer and does not discriminate in its personnel practices against its partners or qualified applicants for employment based on race, color, religion, sex, national origin or because he or she is an individual with a disability or a protected veteran.