| Licensed Practical Nurse - Medical Management Job Description |
 |
| The following is a full job description for Licensed Practical Nurse - Medical Management. Here are the requirements and responsibilities for Licensed Practical Nurse - Medical Management along with statistics. If after reading this page you determine that Licensed Practical Nurse - Medical Management is not the position you are looking for, you may want to try one of these similar titles: Licensed Practical Nurse - Medical Management, Licensed Practical Nurse, Licensed Practical Nurse - Mental Health, Licensed Practical Nurse - Home Care, Licensed Practical Nurse - Outpatient Clinic, Licensed Practical Nurse - Nursing Home/LTC, Registered Nurse II - Medical Management, Registered Nurse III - Medical Management, Medical Management Director, Medical Management Manager |
|
| Requirements and Responsibilities For Licensed Practical Nurse - Medical Management |
| Responsible for coordinating with healthcare providers and plan members to maximize member benefits while managing costs. Assesses medical necessity of patient admissions, surgical and diagnostic procedures, and other related services. Conducts pre-certification and/or authorization, and monitors compliance with established medical guidelines and policies. May assist members in appeals for denied services. Applies the medical and reimbursement policies within the claim adjudication process. May require a bachelor's degree. Requires Licensed Practical Nurse (LPN). Typically reports to a manager. Work is closely managed. Works on projects/matters of limited complexity in a support role. Typically requires 0-2 years of related experience. |
| |
|
| Also referred to as: Medical Management Nurse (LPN), Medical Management Nurse (LVN) |
|
| Similar Jobs: Licensed Practical Nurse - Medical Management, Licensed Practical Nurse, Licensed Practical Nurse - Mental Health, Licensed Practical Nurse - Home Care, Licensed Practical Nurse - Outpatient Clinic, Licensed Practical Nurse - Nursing Home/LTC, Registered Nurse II - Medical Management, Registered Nurse III - Medical Management, Medical Management Director, Medical Management Manager |
|
| Level of Education: Licensed Practical Nurse - Medical Management Salaries with No Diploma, Licensed Practical Nurse - Medical Management Salaries with a High School Diploma or Technical Certificate, Licensed Practical Nurse - Medical Management Salaries with an Associate's Degree, Licensed Practical Nurse - Medical Management Salaries with a Bachelor's Degree, Licensed Practical Nurse - Medical Management Salaries with a Master's Degree or MBA, Licensed Practical Nurse - Medical Management Salaries with a JD, MD, PhD or Equivalent |
|
|
| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
