I recently joined NL and just had an opportunity to check out some of the forums! I am a managed care nurse and watched sicko with quite a bit of interest. I obtained my BSN in 1988 and worked in a large (1100+) public hospital for a few years; initially-med/surg-trauma, and high risk ob. I then went on to work for hh/hospice,--at one point I was a DON of a hh agency. I sort of "fell" into managed care. A fall, I am grateful for every day. 

I do work daily for my patients. All 5 million of them (give or take). I work to ensure they understand what their benefits are and how to best utilize them. There is also the issue of reminding members of their responsibility to their own health and to ensure they are not taken advantage of financially by health care providers. I utilize all of my expertise from all of the specialties I have previously worked, and a good dose of computer savvy to pull it all together. Like all aspects of nursing -most days are great, some not so much. Contrary to what Mr. Moore presented, I have NEVER been asked to make an inappropriate decision on care. What I have found is that as in so many aspects of American society no one wants to take responsibility for themselves or their actions. Patients want procedures that have no sound scientific basis-because they saw it on GMA, or want services that their policies do not cover. I have no problem issuing denials based on "not a covered benefit". There are services my policy doesn't cover, if I want them I pay for them myself.