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)
JOB DUTIES IN ORDER OF IMPORTANCE:
Administers nursing of Ohio under direction of registered nurse, licensed physician, dentist, podiatrist, optometrist or chiropractor (e.g., administers oxygen; applies sterile dressing, inserts catheters; reinserts gastrotomy tubes, suctions, irrigates wounds; gives enemas, douches; collects specimens; performs dialysis treatments, operates hemodialysis equipment & monitors patient during procedure; assists physicians with physical exams, treatments &/or laboratory tests; assists in emergencies by administering first-aid, performing cardio-pulmonary resuscitation &/or restraining patients; administers controlled drugs such as narcotics & min or tranquilizers & no n-controlled medication in oral, rectal, topical or injectable form (i.e., intramuscular & subcutaneous injections only) & provides medication instructions to patients).
Maintains medication accountability records (e.g., charts patient records, prepares & counts medication, maintains medication stock & medical equipment & supplies); observes, documents & reports patient conditions (e.g., medication reactions, treatment responses, patient behavior & progress) & prepares &/or maintains related reports & records (e.g., unusual incident reports, patient records, medication reports, seclusion/restraint logs, patient Kardex, team plan).
Orders medication & medical supplies; cleans nurses station & medication room/medication cart (e.g., cleans, sterilizes & restocks cart; defrosts & cleans medication refrigerator) & performs clerical tasks (e.g., answers phone, files).
MAJOR WORKER CHARACTERISTICS:
Knowledge of skilled licensed practical nursing procedures; pharmacology; client/patient care; first-aid; CPR; general hospital practices & procedures; agency, institutional, hospital or clinic practices & procedures; HIPAA regulations & standards; human relations; inventory control; employee training & development. Skill in use of medical equipment (e.g., respirator, dialysis machine, sterilizer, oxygen equ ipment, blood pressure cuff); hypodermics; operation of person al computer. Ability to understand practical field of study; deal with some abstract but mostly concrete variables; recognize unusual or threatening conditions & take appropriate emergency action; develop good rapport with patients &/or residents; understand manuals & verbal instructions associated with practical nursing; demonstrate dexterity to administer injections & perform medical treatments & strength to move, reposition or restrain patients.
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