Prospective Payment System Coordinator - Now Hiring

About UM Rehab & Ortho Institute With roots dating back to 1895, the UM Rehabilitation & Orthopedic Institute is Maryland's largest provider of inpatient rehabilitation services. Our 141-bed facility serves over 3,000 patients annually, specializing in stroke, spinal cord injury, traumatic brain injury, orthopedic and sports injuries, and more.

Position Overview The PPS Coordinator is responsible for IRF-PAI completion and CMS regulatory compliance. This role serves as an expert resource to the organization and interdisciplinary rehab team, monitoring admissions, length of stay, and clinical documentation to ensure compliance with current regulations.

Key Responsibilities

• Complete the IRF-PAI in accordance with CMS rules and regulations, including selecting the appropriate Impairment Group Code (IGC) based on physician documentation
• Collaborate with the Interdisciplinary Rehabilitation Team to develop comprehensive patient assessments, ensuring accuracy and completeness
• Maintain and update IRF-PAI policies, procedures, and workflows in accordance with annual CMS regulatory updates
• Counsel physicians and providers on clinical documentation improvement and conduct in-service training as needed
• Monitor patient care for quality assurance, utilization review, and risk management
• Evaluate medical necessity for admissions, continued stays, and ancillary services
• Serve as the IRF PPS CMS expert during regulatory audits and compliance surveys

Qualifications

• Master's degree in Physical Therapy with current Maryland Physical Therapist license
• Master's degree in Speech Language Pathology with Certificate of Clinical Competence
• Bachelor's degree or certificate from an accredited Occupational Therapy program with current AOTA registration
• Graduation from an accredited Nursing program with current Maryland RN license (BSN preferred)
• 2–3 years of inpatient rehabilitation or acute care experience, with progressively responsible clinical and/or quality assurance/utilization review experience
• Coursework and experience in research statistics and quality improvement methodology, including chart control techniques (preferred)

Knowledge, Skills & Abilities

• Strong analytical skills with the ability to gather, interpret, and act on data; identify discrepancies; and recommend solutions that ensure regulatory compliance
• High level of communication and interpersonal skills, including the ability to present complex quality improvement information to physicians, clinical staff, patients, and families with tact and discretion
• Technical knowledge of quality improvement and utilization review processes, as well as Medicare, Medicaid, and managed care financial requirements
• Demonstrated leadership skills including decision-making, coaching, teaching, and the ability to build confidence and collaboration across teams
• Strong organizational skills with the ability to manage multiple priorities, implement training programs, and ensure assessments are completed accurately and on time
• Proficiency in computer systems including word processing, spreadsheet, and database software

All your information will be kept confidential according to EEO guidelines.

Compensation:

Pay Range: $38.67 - $58.05 

Other Compensation (if applicable): Relocation Assistance Offered

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