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)
Compiles a list of risks and regulatory challenges for healthcare industries.
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Level 2 Behaviors
(Light Experience)
Assists in implementing industry best practices to secure and protect confidential healthcare information.
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Level 3 Behaviors
(Moderate Experience)
Communicates healthcare policies and procedures to ensure compliance with professional practice standards.
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Level 4 Behaviors
(Extensive Experience)
Delivers healthcare education and training programs to bridge skill gaps in our organization.
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Level 5 Behaviors
(Mastery)
Designs and implements cost-effective strategies to optimize resource utilization within healthcare settings.
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2
Job Family Competencies –
Healthcare Knowledge
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Identifies different types of healthcare knowledge and describes the significance of each.
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Level 2 Behaviors
(Light Experience)
Supports healthcare audits to gather sources for the creation of knowledge management strategies.
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Level 3 Behaviors
(Moderate Experience)
Works with various medical professionals in processing healthcare data to meet patient needs.
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Level 4 Behaviors
(Extensive Experience)
Promotes the use of knowledge management systems to improve efficiencies across healthcare service operations.
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Level 5 Behaviors
(Mastery)
Leads the development of service quality improvement plans to maximize patient satisfaction and retention.
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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)
Lists the traits of an employee showing great attention to detail.
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Level 2 Behaviors
(Light Experience)
Utilizes specific approaches and tools for checking and cross-checking outputs.
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Level 3 Behaviors
(Moderate Experience)
Uses tools to organize and monitor work progress.
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Level 4 Behaviors
(Extensive Experience)
Manages training to improve staffs' concentration and attention to detail.
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Level 5 Behaviors
(Mastery)
Learns from previous works' strengths and weaknesses to guide new projects.
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2
Core Competencies –
Time Management
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Lists basic planning tools and applications used in tracking and organizing time and tasks visually.
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Level 2 Behaviors
(Light Experience)
Seeks all resources needed to accomplish a task efficiently and effectively.
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Level 3 Behaviors
(Moderate Experience)
Works closely with colleagues to identify and reduce interruptions and barriers to time utilization.
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Level 4 Behaviors
(Extensive Experience)
Provides strategic direction to the workforce in managing time to avoid low-value work.
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Level 5 Behaviors
(Mastery)
Monitors the performance of business units to determine and eliminate deviations from priorities.
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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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