…Practitioner License with prescriptive privileges - AND National certification as an Acute Care Nurse Practitioner * Physician Assistant: - Licensure as a

…cancer care . Nurses in these units specialize in centralizing the care of medically managed patients who have received chemotherapy treatments. Ongoing

…Is familiar with basic medical insurance concepts (ie: deductibles, co-insurance, fee-for-service, managed care ) + Verifies and explains charges to the patient.

…**OB/GYN** **Virginia, MN** PRACTICE SPECIFICS + 1:4 community call + 1 OB/GYN Nurse Practitioner to support practice + 300 deliveries/year at the hospital - Average

…all on-site as well as others available at the main campus in Duluth + Nurse -on-line triage 24/7 + EPIC (electronic medical records) in clinic and hospital + Admit

…specifications, required + Six or more years of clinic or IPA and/or managed care experience, preferred + Knowledge of Medicare Advantage billing/claims

…coordinating follow-up care to the patient/family + Understands payer principles, terminology of managed care , and the goals of managed care .

…abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care , and private sources, as applicable. Demonstrate extensive advanced

…- Verify insurance through all resources - Obtain all necessary paperwork from Managed Care companies including authorizations and denials for admission -

…personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting and other institutional departments to ensure