Skills & Competencies for Staff Nurse - RN - Medical Management
Staff Nurse - RN - Medical Management job profile
Book a Demo and Receive a Sample Job ProfileJOB SUMMARY for Staff Nurse - RN - Medical Management
Coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs.
JOB RESPONSIBILITIES for Staff Nurse - RN - Medical Management
Assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Assists members in appeals for denied services. Interprets benefits and guides members to choose to the appropriate providers, projects and resources.
Staff Nurse - RN - Medical Management SALARY RANGE
BASE 50%
$86,411
TOTAL 50%
$89,745
Job Level
P02
Job Code
HC07000621
Education/Degree
Bachelor's Degree
Reports To
Manager
Staff Nurse - RN - Medical Management Skills and Competencies List
9 general skills or competencies (Job family competencies) for Staff Nurse - RN - Medical Management
1
Job Family Competencies –
Healthcare Industry
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Explains the clinical benefits of integrating innovations and technological advances into healthcare services.
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Level 2 Behaviors
(Light Experience)
Supports the development of innovative healthcare practices to reduce healthcare costs.
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Level 3 Behaviors
(Moderate Experience)
Leverages advanced analytics to improve patient-based service outcomes.
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Level 4 Behaviors
(Extensive Experience)
Integrates advanced processes into clinical workflows to diagnose and treat diseases more precisely.
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Level 5 Behaviors
(Mastery)
Leads the development of services and solutions to address complex healthcare industry challenges.
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2
Job Family Competencies –
Healthcare Knowledge
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Explains the importance of healthcare services in disease prevention and control.
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Level 2 Behaviors
(Light Experience)
Records healthcare information using different mediums for transmission.
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Level 3 Behaviors
(Moderate Experience)
Uses a healthcare system to maintain resources for evidence-based research for the organization.
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Level 4 Behaviors
(Extensive Experience)
Manages the creation, coordination, and execution of valuable healthcare programs within the organization.
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Level 5 Behaviors
(Mastery)
Establishes a "knowledge-sharing" environment to contribute to breakthroughs in the healthcare service industry.
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3
Staff Nurse - RN - Medical Management
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Staff Nurse - RN - Medical Management
Proficiency Level - 4
5
Competency for -
Staff Nurse - RN - Medical Management
Proficiency Level - 5
5 soft skills or competencies (core competencies) for Staff Nurse - RN - Medical Management
1
Core Competencies –
Attention to Detail
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Cites steps and tips to improve attention to detail in the workplace.
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Level 2 Behaviors
(Light Experience)
Keeps full attention when listening to understand the message.
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Level 3 Behaviors
(Moderate Experience)
Balances between accuracy and efficiency for different tasks or programs.
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Level 4 Behaviors
(Extensive Experience)
Creates and implements quality management processes for our business.
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Level 5 Behaviors
(Mastery)
Defines possible hurdles to projects and creates strategies to deal with them.
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2
Core Competencies –
Time Management
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Cites examples of prioritization methods used to manage and save time in the workplace.
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Level 2 Behaviors
(Light Experience)
Adheres to schedules to allocate time for specific tasks efficiently.
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Level 3 Behaviors
(Moderate Experience)
Assesses relevance of tasks to prioritize and produce better quality work.
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Level 4 Behaviors
(Extensive Experience)
Creates programs to develop our employees' understanding of time demand and management.
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Level 5 Behaviors
(Mastery)
Builds a system to manage our business's workload and eliminate time-wasting activities.
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3
Staff Nurse - RN - Medical Management
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Staff Nurse - RN - Medical Management
Proficiency Level - 4
5
Competency for -
Staff Nurse - RN - Medical Management
Proficiency Level - 5
Summary of Staff Nurse - RN - Medical Management skills and competencies
There are 0 hard skills for Staff Nurse - RN - Medical Management.
9 general skills for Staff Nurse - RN - Medical Management, Healthcare Industry, Healthcare Knowledge, Healthcare Regulatory Environment, etc.
5 soft skills for Staff Nurse - RN - Medical Management, Attention to Detail, Time Management, Initiative, etc.
While the list totals 14 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Staff Nurse - RN - Medical Management, he or she needs to be proficient in Attention to Detail, be proficient in Time Management, and be proficient in Initiative.
9 general skills for Staff Nurse - RN - Medical Management, Healthcare Industry, Healthcare Knowledge, Healthcare Regulatory Environment, etc.
5 soft skills for Staff Nurse - RN - Medical Management, Attention to Detail, Time Management, Initiative, etc.
While the list totals 14 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Staff Nurse - RN - Medical Management, he or she needs to be proficient in Attention to Detail, be proficient in Time Management, and be proficient in Initiative.
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