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%
$68,106
TOTAL 50%
$69,596
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)
Follows methods, standards, and cost analysis systems to promote quality improvement.
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Level 2 Behaviors
(Light Experience)
Suggests needed changes in the existing process to correct and/or eliminate quality issues.
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Level 3 Behaviors
(Moderate Experience)
Partners with the senior management in developing continuous improvement plans to drive excellence.
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Level 4 Behaviors
(Extensive Experience)
Oversees the identification of process improvement opportunities to achieve quality targets.
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Level 5 Behaviors
(Mastery)
Establishes an effective quality management system to identify opportunities 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)
Records medical history, current financial and living status, and social support situation of clients.
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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)
Records all appointments on the calendar to easily track daily activities.
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Level 3 Behaviors
(Moderate Experience)
Sets up processes to ensure delivery of high-quality work.
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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)
Employs the 80-20 rule to avoid perfectionism and minimize time-wasting.
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Level 3 Behaviors
(Moderate Experience)
Handles workplace obstacles to maintain focus and manage time efficiently.
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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)
Keeps current on the latest working models on time management to drive organizational productivity.
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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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