Staff Nurse - RN - Medical Management coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Being a Staff Nurse - RN - Medical Management assists members in appeals for denied services. Interprets benefits and guides members to choose to the appropriate providers, projects and resources. Additionally, Staff Nurse - RN - Medical Management typically requires a bachelor's degree in nursing. Typically reports to a manager. Requires a valid state RN license. To be a Staff Nurse - RN - Medical Management typically requires 3-5 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
PURPOSE AND SCOPE:
The professional registered nurse Home Therapies RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. This position is accountable and responsible for the provision and coordination of clinically competent care including assessment planning intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team this position participates in decision-making teaching leadership functions and quality improvement activities that enhance patient care outcomes and facility operations.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy procedures standards of nursing practice state and federal regulations.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
SUPERVISION:
Assigned oversight of RNs LPNs/LVNs Patient Care Technicians and Home Therapies Care Team Assistants as a Team Leader or designated Nurse in Charge after meeting all the following:
EDUCATION and LICENSURE:
EXPERIENCE AND REQUIRED SKILLS:
Entry level for RNs with a minimum of 2 years or more of Nephrology Nursing experience within the last 2 years as a RN.
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity
Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.
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