Skills & Competencies for Licensed Practical Nurse - Medical Management
Licensed Practical Nurse - Medical Management job profile
Book a Demo and Receive a Sample Job ProfileJOB SUMMARY for Licensed Practical Nurse - Medical Management
Coordinates with healthcare providers and plan members to maximize member benefits while managing costs.
JOB RESPONSIBILITIES for Licensed Practical Nurse - Medical Management
Assesses medical necessity of patient admissions, surgical and diagnostic procedures, and other related services. Conducts pre-certification or authorization, and monitors compliance with established medical guidelines and policies. May assist members in appeals for denied services.
Licensed Practical Nurse - Medical Management SALARY RANGE
BASE 50%
$67,930
TOTAL 50%
$69,417
Job Level
AZ0
Job Code
HC07000595
Education/Degree
High School Diploma or Technical Certificate
Reports To
Registered Nurse or Supervisor
Licensed Practical Nurse - Medical Management Skills and Competencies List
9 general skills or competencies (Job family competencies) for Licensed Practical Nurse - Medical Management
1
Job Family Competencies –
Quality Improvement
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Discusses practice workflows to identify opportunities for process and quality improvement.
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Level 2 Behaviors
(Light Experience)
Documents quality audits, results, and key metrics to drive continuous improvement activities.
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Level 3 Behaviors
(Moderate Experience)
Participates in improvement activities related to quality and key performance indicators.
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Level 4 Behaviors
(Extensive Experience)
Investigates internal quality issues to provide recommendations on process improvements.
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Level 5 Behaviors
(Mastery)
Conceptualizes automated processes to analyze quality systems for improvement.
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2
Job Family Competencies –
Case Management
Proficiency Level -1
Level 1 Behaviors
(General Familiarity)
Explains the differences between the brokerage, strengths-based, and clinical case management models.
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Level 2 Behaviors
(Light Experience)
Schedules patients’ medical appointments and conducts follow-ups to ensure they attended their consultations.
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Level 3 Behaviors
(Moderate Experience)
Provides a customized care plan to clients based on their medical history and current financial and living situation.
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Level 4 Behaviors
(Extensive Experience)
Partners with healthcare and human services providers to increase client satisfaction and promote cost-effectiveness.
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Level 5 Behaviors
(Mastery)
Redefines ineffectual case management programs to deliver high-quality healthcare services and attain client objectives.
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3
Licensed Practical Nurse - Medical Management
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Licensed Practical Nurse - Medical Management
Proficiency Level - 4
5
Competency for -
Licensed Practical Nurse - Medical Management
Proficiency Level - 5
6 soft skills or competencies (core competencies) for Licensed Practical Nurse - Medical Management
1
Core Competencies –
Attention to Detail
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Lists best practices and tools to maintain high accuracy and thoroughness in the workplace.
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Level 2 Behaviors
(Light Experience)
Uses checklists to ensure that information goes out error-free.
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Level 3 Behaviors
(Moderate Experience)
Suggests solutions to issues that arise while executing the tasks.
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Level 4 Behaviors
(Extensive Experience)
Employs techniques for motivating personnel to meet or exceed accuracy goals.
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Level 5 Behaviors
(Mastery)
Leads the creation of tools for enhancing and assuring accuracy.
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2
Core Competencies –
Time Management
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Explains the importance of time management in driving the overall productivity of our business.
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Level 2 Behaviors
(Light Experience)
Follows an updated calendar to list and complete tasks and assignments according to priority level.
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Level 3 Behaviors
(Moderate Experience)
Utilizes departmental tools and best practices to organize tasks effectively and productively.
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Level 4 Behaviors
(Extensive Experience)
Manages teams in streamlining work-related tasks to prioritize highest value tasks firsts.
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Level 5 Behaviors
(Mastery)
Leads transformational changes to work plans to drive the proper utilization of time and resources.
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3
Licensed Practical Nurse - Medical Management
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Licensed Practical Nurse - Medical Management
Proficiency Level - 4
5
Competency for -
Licensed Practical Nurse - Medical Management
Proficiency Level - 5
Summary of Licensed Practical Nurse - Medical Management skills and competencies
There are 0 hard skills for Licensed Practical Nurse - Medical Management.
9 general skills for Licensed Practical Nurse - Medical Management, Quality Improvement, Case Management, Managed Care Management, etc.
6 soft skills for Licensed Practical Nurse - Medical Management, Attention to Detail, Time Management, Flexibility, etc.
While the list totals 15 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 Licensed Practical Nurse - Medical Management, he or she needs to be proficient in Attention to Detail, be proficient in Time Management, and be proficient in Flexibility.
9 general skills for Licensed Practical Nurse - Medical Management, Quality Improvement, Case Management, Managed Care Management, etc.
6 soft skills for Licensed Practical Nurse - Medical Management, Attention to Detail, Time Management, Flexibility, etc.
While the list totals 15 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 Licensed Practical Nurse - Medical Management, he or she needs to be proficient in Attention to Detail, be proficient in Time Management, and be proficient in Flexibility.
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