Licensed Practical Nurse - Medical Management coordinates 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. Being a Licensed Practical Nurse - Medical Management conducts pre-certification or authorization, and monitors compliance with established medical guidelines and policies. May assist members in appeals for denied services. Additionally, Licensed Practical Nurse - Medical Management requires a high school diploma. Typically reports to a registered nurse or supervisor. Requires graduation from approved LPN educational program. Requires a state license to practice. Licensed Practical Nurse - Medical Management's years of experience requirement may be unspecified. Certification and/or licensing in the position's specialty is the main requirement. (Copyright 2024 Salary.com)
Description
Position Summary
The Licensed Practical Nurse in LECH is responsible for providing quality patient care and performing technical skilled care.
Primary Responsibilities
1. Provides high quality clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team, following all applicable infection control procedures. Does not alter the plan of care.
2. Continually observes and reports the patient’s nursing needs to supervising RN.
3. Communicates timely and effectively with physicians, patients, family members, and appropriate agency staff regarding any patient care issues or needs, visit assignments, dates of scheduled visits, and schedule changes to scheduler, orders and OASIS data sets, coding requests, schedule home visits to coordinate care with other clinicians, and deliver services to patient as ordered by physician and in accordance with applicable laws and regulations.
4. Documents patient visits thoroughly and completely per policy and payer requirements and syncs timely per LHC policy. This includes maintaining an accurate and current medication listing.
5. Actively participates in the performance improvement plan, constantly works to reduce patient hospitalizations, and improve outcomes and processes to ensure positive patient outcomes.
6. Attends and actively participates in all meetings including case conference and is punctual. This includes having a camera on for video meetings.
7. Attends work each day with a positive attitude, willing to help the patient and agency in any way they can and is open to learning new skills.
8. Adheres to and participates in the agency’s Episode Management process.
9. All other duties as assigned.
Competencies
1. Computer and technology literacy.
2. Time management.
3. Strong communication skills, verbally and written.
4. Ability to work with others.
5. Ability to use appropriate discretion in handling confidential material and information.
Supervisory Responsibility
None.
Requirements
Required Education and Experience
1. Current LPN license in state of practice.
2. Current driver’s license, vehicle insurance, and access to a dependable vehicle or public transportation.
3. CPR certification.
4. Minimum one-year experience working as an LPN.
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