Home › Companies › Mnh Ibosjb Fa Ocs Oraclecloud Com CX 1 › Manager Case Management
Manager Case Management
Mnh Ibosjb Fa Ocs Oraclecloud Com CX 1 · State College, PA, United States; Medical Center, State College, PA, US · Active · Oracle Recruiting Cloud / Fusion HCM
Job facts
| Field | Value |
|---|---|
| Company | Mnh Ibosjb Fa Ocs Oraclecloud Com CX 1 |
| Title | Manager Case Management |
| Normalized title | - |
| Department / team | Nursing and Patient Care Services |
| Location | State College, PA, United States |
| Work model | - |
| Employment type | - |
| Salary | - |
| Status | active |
| ATS provider | Oracle Recruiting Cloud / Fusion HCM |
| Posted / first seen | 2026-04-15 / 2026-05-31 |
| Changed / last seen | 2026-05-31 / 2026-06-06 |
Related slices
| Page | What it contains | Open |
|---|---|---|
| Company jobs | Active postings from Mnh Ibosjb Fa Ocs Oraclecloud Com CX 1. | Open |
| Company breakdowns | Role, location, ATS, and work model facets for this company. | Open |
| ATS provider jobs | Active postings observed through Oracle Recruiting Cloud / Fusion HCM. | Open |
| Provider filtered search | The same provider as a filtered job collection. | Open |
| City jobs | Active postings in State College. | Open |
| Department jobs | Active postings in Nursing and Patient Care Services. | Open |
| Lifecycle events | Open, update, close, and reopen events for this posting. | Open |
| Original posting | Canonical source or apply URL captured from the ATS. | Open |
Linked records
| Company | Mnh Ibosjb Fa Ocs Oraclecloud Com CX 1 |
| Source | a93a3c80-a4ad-4123-bc9e-4c481910e55a |
| ATS provider | Oracle Recruiting Cloud / Fusion HCM |
Description
Description
POSITION SUMMARY
Under the supervision of the Director assumes responsibility in managing the human and material resources of the Case Management Department in order to provide quality patient care and an environment conducive to staff growth and professional performance. This individual remains clinically competent in area of practice. Interprets and enforces policies and procedures, standards of care and standards of practice with others and demonstrates same through own actions. This individual remains clinically competent in the area of practice and is able to take a direct patient assignment as needed.
LEADERSHIP VALUES
The MNH Leadership Values we are striving to emulate:
• Respect, appreciation and caring for all-positive outlook
• Initiative, achievement oriented, drive for excellence and continuous improvement; perseverance and ability to see the big picture
• Teamwork and support for others; interdependence and commitment to the collective; system success as opposed to individual achievement or credit
• Open, respectful, candid communication; handles conflicts and differing points of view directly; doesn’t shy away from difficult issues or conversations
• Stewardship of resources and passion for efficiency
• Ownership of actions and results focused
• Resilient; adaptable to change; perseveres in the midst of challenges
• Courage
MINIMUM REQUIREMENTS
Education:
Bachelor of Science Degree in Nursing, Social Work or related Health field required.
Master’s Degree preferred
Experience:
1. Five years of Case Management experience required.
2. 1 year supervisory experience required.
Knowledge, Skills, Abilities:
Demonstrated leadership and interpersonal skills.
Ability to work effectively under stressful situations.
Demonstrated oral and written communication skills.
Ability to function in an independent manner with little or no need for direct supervision.
Effectively communicates verbally with patients, physicians, visitors, co-workers and supervisors.
Ability to document data and other information.
Ability to read and interpret written communication.
Ability to speak, read, and writes the English language.
Conducts business in a professional and cordial manner that upholds the integrity and reputation of Mount Nittany Medical Center.
Knowledge of human resource laws and regulations as they relate to the management of staff.
License/Certification/Registration:
Current licensure as a professional registered nurse in the Commonwealth of Pennsylvania or LMSW/LCSW (Social Work) license preferred.
Certified Case Manager (CCM) preferred.
Meets the American Heart Association’s standards for Healthcare Provider Basic Life Support (BLS) and renews BLS every two years.
SUPERVISION RECEIVED
Works independently to achieve departmental goals and objectives consulting with the Director as needed and/or in accordance with established policy.
SUPERVISION GIVEN
Supervises assigned staff in the Case Management Department.
Responsibilities
ESSENTIAL FUNCTIONS
Manages assigned unit personnel. Provides day-to-day supervision of case management activities.
Strategic Oversight: Develops and implements case management programs, including utilization review, intake, and discharge planning.
Coordinates and collaborates with staff to plan unit/ patient assignments according to staff education, training and ability, standards of care and patient needs.
Actively participates in recruiting, interviewing and selecting unit staff. Participates in and/or conducts performance reviews, as well as counseling and discipline of unit staff.
Ensures staff meet the minimum qualifications of their positions at all times including licensure, certification and registration.
Plans and evaluates work flow for continuity of patient services which assures collaboration with health care team; enhances cost management.
Actively participates in Inter Rater Reliability monitoring of staff. Performs document review of data entry for completeness, accuracy, and clarity of documentation submitted by case managers per record audit policy and procedures. Seeks corrections, completion and /or clarification from case managers and data entry when necessary, providing education/ instruction and reinforcement of policy and procedures.
Monitors case management activities and time-line compliance through monitoring of case management reports and logs
Coordinates the orientation process for new employees.
Monitors observation, admission, and length of stay data on a monthly basis.
Resource Management: Monitors departmental budgets, expenses, and the use of medical resources to enhance cost-effectiveness
Regulatory Compliance: Ensures all practices meet federal, state, and organizational guidelines, such as Medicare/Medicaid/ Commercial requirements and JCAHO standards
Facilitates communication regarding patient care.
Acts as a liaison with the medical staff to coordinate medical and nursing management of patient care.
Serves as resource for conflict resolution when patient issues are unresolved by primary care givers.
Presents changes and innovations in a positive manner.
Manages patient care/ Assuring Quality Discharge Planning
Performance Monitoring: Analyzes patient care data and key care indicators to identify trends, reduce delays, and improve clinical outcomes.
Assures that patients have received assessment and reassessment of physical care, psychosocial support and education to be discharged safely.
Assures collaboration with appropriate other health care providers resulting in formulation of a nursing diagnosis and initiation/revision of a care plan consistent with the medical plan of care.
Actively participates in utilization management of patients across the continuum of care.
Monitors readmissions.
Monitors participation in Daily Discharge Rounding’s for each unit.
Coordinates interactions with other health care facilities, community agencies and the public as appropriate with regard to assigned areas of responsibility and operations.
Denial Management
Utilizes Best Practice strategies for Denial Management.
Assumes the primary responsibility of denial management Axis program.
Manages in coordination with Director the appeals management process.
Serves as liaison with the finance/ billing department for claims issues.
Monitors concurrent and retrospective denials.
Builds and maintains effective relationships with the payers.
Works collaboratively with the Physician Advisor.
Participates in the UR Committee – reporting monthly denial management activity as requested.
Manages personal professional growth and development as well as the unit’s staff.
Demonstrates the qualities of advocate, role model, mentor and facilitator during growth and development of self, nursing staff and other health care team members.
Delegates appropriately and provides unity of command; assists staff with delegated responsibilities.
Provides leadership, direction and remediation to unit specific nursing personnel in accordance with organizational, departmental and governing agency goals, objectives and standards.
Team Leadership: Manages, mentors, and evaluates a team of case managers and social workers to ensure high-quality care.
NON-ESSENTIAL FUNCTIONS
Performs related and miscellaneous duties as assigned.
Company
Why Mount Nittany Health?
At Mount Nittany Health, we provide high-quality patient care with a unique combination of the latest in clinical technology and compassionate medical professionals. We are committed to improving both the quality and availability of healthcare in our region and seek to hire only the best to support the communities we serve.
Full job record
| Job ID | 671b40cf4c571f87e0bece228d02093767ea1427 |
| Org ID | acad372e-e03a-4e69-b5b3-6ffd8098ded7 |
| Source ID | a93a3c80-a4ad-4123-bc9e-4c481910e55a |
| Board ID | a93a3c80-a4ad-4123-bc9e-4c481910e55a |
| Provider | oracle_hcm |
| Provider Job Key | 2929 |
| Title | Manager Case Management |
| Normalized Title | — |
| Status | active |
| Active | yes |
| Location Text | State College, PA, United States; Medical Center, State College, PA, US |
| Department | Nursing and Patient Care Services |
| Team | — |
| Employment Type | — |
| Workplace Type | — |
| Remote Policy | — |
| Country | United States |
| Region | PA |
| City | State College |
| Salary Raw | Description POSITION SUMMARY Under the supervision of the Director assumes responsibility in managing the human and material resources of the Case Management Department in order to provide quality patient care and an environment conducive to staff growth and professional performance. This individual remains clinically competent in area of practice. Interprets and enforces policies and procedures, standards of care and standards of practice with others and demonstrates same through own actions. This individual remains clinically competent in the area of practice and is able to take a direct patient assignment as needed. LEADERSHIP VALUES The MNH Leadership Values we are striving to emulate: • Respect, appreciation and caring for all-positive outlook • Initiative, achievement oriented, drive for excellence and continuous improvement; perseverance and ability to see the big picture • Teamwork and support for others; interdependence and commitment to the collective; system success as opposed to individual achievement or credit • Open, respectful, candid communication; handles conflicts and differing points of view directly; doesn’t shy away from difficult issues or conversations • Stewardship of resources and passion for efficiency • Ownership of actions and results focused • Resilient; adaptable to change; perseveres in the midst of challenges • Courage MINIMUM REQUIREMENTS Education: Bachelor of Science Degree in Nursing, Social Work or related Health field required. Master’s Degree preferred Experience: 1. Five years of Case Management experience required. 2. 1 year supervisory experience required. Knowledge, Skills, Abilities: Demonstrated leadership and interpersonal skills. Ability to work effectively under stressful situations. Demonstrated oral and written communication skills. Ability to function in an independent manner with little or no need for direct supervision. Effectively communicates verbally with patients, physicians, visitors, co-workers and supervisors. Ability to document data and other information. Ability to read and interpret written communication. Ability to speak, read, and writes the English language. Conducts business in a professional and cordial manner that upholds the integrity and reputation of Mount Nittany Medical Center. Knowledge of human resource laws and regulations as they relate to the management of staff. License/Certification/Registration: Current licensure as a professional registered nurse in the Commonwealth of Pennsylvania or LMSW/LCSW (Social Work) license preferred. Certified Case Manager (CCM) preferred. Meets the American Heart Association’s standards for Healthcare Provider Basic Life Support (BLS) and renews BLS every two years. SUPERVISION RECEIVED Works independently to achieve departmental goals and objectives consulting with the Director as needed and/or in accordance with established policy. SUPERVISION GIVEN Supervises assigned staff in the Case Management Department. Responsibilities ESSENTIAL FUNCTIONS Manages assigned unit personnel. Provides day-to-day supervision of case management activities. Strategic Oversight: Develops and implements case management programs, including utilization review, intake, and discharge planning. Coordinates and collaborates with staff to plan unit/ patient assignments according to staff education, training and ability, standards of care and patient needs. Actively participates in recruiting, interviewing and selecting unit staff. Participates in and/or conducts performance reviews, as well as counseling and discipline of unit staff. Ensures staff meet the minimum qualifications of their positions at all times including licensure, certification and registration. Plans and evaluates work flow for continuity of patient services which assures collaboration with health care team; enhances cost management. Actively participates in Inter Rater Reliability monitoring of staff. Performs document review of data entry for completeness, accuracy, and clarity of documentation submitted by case managers per record audit policy and procedures. Seeks corrections, completion and /or clarification from case managers and data entry when necessary, providing education/ instruction and reinforcement of policy and procedures. Monitors case management activities and time-line compliance through monitoring of case management reports and logs Coordinates the orientation process for new employees. Monitors observation, admission, and length of stay data on a monthly basis. Resource Management: Monitors departmental budgets, expenses, and the use of medical resources to enhance cost-effectiveness Regulatory Compliance: Ensures all practices meet federal, state, and organizational guidelines, such as Medicare/Medicaid/ Commercial requirements and JCAHO standards Facilitates communication regarding patient care. Acts as a liaison with the medical staff to coordinate medical and nursing management of patient care. Serves as resource for conflict resolution when patient issues are unresolved by primary care givers. Presents changes and innovations in a positive manner. Manages patient care/ Assuring Quality Discharge Planning Performance Monitoring: Analyzes patient care data and key care indicators to identify trends, reduce delays, and improve clinical outcomes. Assures that patients have received assessment and reassessment of physical care, psychosocial support and education to be discharged safely. Assures collaboration with appropriate other health care providers resulting in formulation of a nursing diagnosis and initiation/revision of a care plan consistent with the medical plan of care. Actively participates in utilization management of patients across the continuum of care. Monitors readmissions. Monitors participation in Daily Discharge Rounding’s for each unit. Coordinates interactions with other health care facilities, community agencies and the public as appropriate with regard to assigned areas of responsibility and operations. Denial Management Utilizes Best Practice strategies for Denial Management. Assumes the primary responsibility of denial management Axis program. Manages in coordination with Director the appeals management process. Serves as liaison with the finance/ billing department for claims issues. Monitors concurrent and retrospective denials. Builds and maintains effective relationships with the payers. Works collaboratively with the Physician Advisor. Participates in the UR Committee – reporting monthly denial management activity as requested. Manages personal professional growth and development as well as the unit’s staff. Demonstrates the qualities of advocate, role model, mentor and facilitator during growth and development of self, nursing staff and other health care team members. Delegates appropriately and provides unity of command; assists staff with delegated responsibilities. Provides leadership, direction and remediation to unit specific nursing personnel in accordance with organizational, departmental and governing agency goals, objectives and standards. Team Leadership: Manages, mentors, and evaluates a team of case managers and social workers to ensure high-quality care. NON-ESSENTIAL FUNCTIONS Performs related and miscellaneous duties as assigned. Company Why Mount Nittany Health? At Mount Nittany Health, we provide high-quality patient care with a unique combination of the latest in clinical technology and compassionate medical professionals. We are committed to improving both the quality and availability of healthcare in our region and seek to hire only the best to support the communities we serve. |
| Salary Min | — |
| Salary Max | — |
| Salary Currency | — |
| Salary Period | day |
| Source URL | https://mnh-ibosjb.fa.ocs.oraclecloud.com/hcmUI/CandidateExperience/en/sites/MountNittanyHealthCareers/job/2929 |
| Apply URL | https://mnh-ibosjb.fa.ocs.oraclecloud.com/hcmUI/CandidateExperience/en/sites/MountNittanyHealthCareers/job/2929 |
| First Seen At | 2026-05-31 18:07:27Z |
| Last Seen At | 2026-06-06 11:14:04Z |
| Last Checked At | 2026-06-06 11:14:04Z |
| Last Changed At | 2026-05-31 18:07:27Z |
| Inactive At | — |
| Source Posted At | 2026-04-15 17:09:40Z |
| Source Updated At | — |
| Raw Payload Uri | s3://job-postings-prod-raw-590183727216/raw/provider=oracle_hcm/board=mnh-ibosjb.fa.ocs.oraclecloud.com|CX_1/date=2026-06-06/2026-06-06T11-13-47-655Z-58c887ec0cdf4b8e48dcc3d003ae0c52a6064cecad9c4f4fd1c0c5ce901b0160.json |
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"ExternalDescriptionStr": "<p><strong><u>POSITION SUMMARY</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 6pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Under the supervision of the Director assumes responsibility in managing the human and material resources of the Case Management Department in order to provide quality patient care and an environment conducive to staff growth and professional performance. This individual remains clinically competent in area of practice. Interprets and enforces policies and procedures, standards of care and standards of practice with others and demonstrates same through own actions. This individual remains clinically competent in the area of practice and is able to take a direct patient assignment as needed.</span></span></p><p><strong><u>LEADERSHIP VALUES</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 6pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">The MNH Leadership Values we are striving to emulate:</span></span></p><p style=\"line-height: normal; margin: 13.45pt 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Respect, appreciation and caring for all-positive outlook </span></span></p><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Initiative, achievement oriented, drive for excellence and continuous improvement; perseverance and ability to see the big picture</span></span></p><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Teamwork and support for others; interdependence and commitment to the collective; system success as opposed to individual achievement or credit </span></span></p><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Open, respectful, candid communication; handles conflicts and differing points of view directly; doesn’t shy away from difficult issues or conversations </span></span></p><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Stewardship of resources and passion for efficiency</span></span></p><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ownership of actions and results focused </span></span></p><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Resilient; adaptable to change; perseveres in the midst of challenges </span></span></p><p style=\"line-height: normal; margin: 0in 0in 13.45pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">•</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Courage </span></span></p><p><strong><u>MINIMUM REQUIREMENTS</u></strong></p><p><strong><u>Education:</u></strong></p><ol style=\"padding-left: 83.13px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 13.45pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Bachelor of Science Degree in Nursing, Social Work or related Health field required.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 13.45pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Master’s Degree preferred</span></span></p></li></ol><p><strong><u>Experience:</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 0in 0.0001pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">1.</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Five years of Case Management experience required.</span></span></p><p style=\"line-height: normal; margin: 0in 0in 13.45pt 62.7pt; text-indent: -28.35pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">2.</span></span><span style=\"font-family: inherit;\"><span style=\"font-size: 12pt;\"> </span></span><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">1 year supervisory experience required.</span></span></p><p><strong><u>Knowledge, Skills, Abilities:</u></strong></p><ol style=\"padding-left: 83.13px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 13.45pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Demonstrated leadership and interpersonal skills.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ability to work effectively under stressful situations.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Demonstrated oral and written communication skills.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ability to function in an independent manner with little or no need for direct supervision.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Effectively communicates verbally with patients, physicians, visitors, co-workers and supervisors.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ability to document data and other information.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ability to read and interpret written communication.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ability to speak, read, and writes the English language.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Conducts business in a professional and cordial manner that upholds the integrity and reputation of Mount Nittany Medical Center.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 13.45pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Knowledge of human resource laws and regulations as they relate to the management of staff.</span></span></p></li></ol><p style=\"line-height: normal; margin-bottom: 13.45pt; margin-right: 0in; margin-top: 0in;\"> </p><p><strong><u>License/Certification/Registration:</u></strong></p><ol style=\"padding-left: 83.13px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 13.45pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Current licensure as a professional registered nurse in the Commonwealth of Pennsylvania or LMSW/LCSW (Social Work) license preferred.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Certified Case Manager (CCM) preferred.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 13.45pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Meets the American Heart Association’s standards for Healthcare Provider Basic Life Support (BLS) and renews BLS every two years.</span></span></p></li></ol><p style=\"line-height: normal; margin-bottom: 13.45pt; margin-right: 0in; margin-top: 0in;\"> </p><p><strong><u>SUPERVISION RECEIVED</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 6pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Works independently to achieve departmental goals and objectives consulting with the Director as needed and/or in accordance with established policy.</span></span></p><p><strong><u>SUPERVISION GIVEN</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 6pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Supervises assigned staff in the Case Management Department. </span></span></p>",
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"PrimaryLocationCountry": "US",
"CorporateDescriptionStr": "<div>\n <b>Why Mount Nittany Health?</b>\n</div>\n<div>\n <b><br></b>\n</div>\n<div>\n At Mount Nittany Health, we provide high-quality patient care with a unique combination of the latest in clinical technology and compassionate medical professionals. We are committed to improving both the quality and availability of healthcare in our region and seek to hire only the best to support the communities we serve.\n</div>",
"ExternalPostedStartDate": "2026-04-15T17:09:40+00:00",
"ExternalQualificationsStr": "",
"InternalQualificationsStr": "",
"OrganizationDescriptionStr": "",
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{
"Latitude": "40.79373",
"Longitude": "-77.8607",
"CountryCode": "US",
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],
"ExternalResponsibilitiesStr": "<p><strong><u>ESSENTIAL FUNCTIONS</u></strong></p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages assigned unit personnel. Provides day-to-day supervision of case management activities. </span></span></p><ol style=\"padding-left: 83.13px;\"><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Strategic Oversight: Develops and implements case management programs, including utilization review, intake, and discharge planning.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Coordinates and collaborates with staff to plan unit/ patient assignments according to staff education, training and ability, standards of care and patient needs.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Actively participates in recruiting, interviewing and selecting unit staff. Participates in and/or conducts performance reviews, as well as counseling and discipline of unit staff.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ensures staff meet the minimum qualifications of their positions at all times including licensure, certification and registration.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Plans and evaluates work flow for continuity of patient services which assures collaboration with health care team; enhances cost management.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Actively participates in Inter Rater Reliability monitoring of staff. Performs document review of data entry for completeness, accuracy, and clarity of documentation submitted by case managers per record audit policy and procedures. Seeks corrections, completion and /or clarification from case managers and data entry when necessary, providing education/ instruction and reinforcement of policy and procedures. </span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors case management activities and time-line compliance through monitoring of case management reports and logs</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Coordinates the orientation process for new employees.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors observation, admission, and length of stay data on a monthly basis. </span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Resource Management: Monitors departmental budgets, expenses, and the use of medical resources to enhance cost-effectiveness</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Regulatory Compliance: Ensures all practices meet federal, state, and organizational guidelines, such as Medicare/Medicaid/ Commercial requirements and JCAHO standards</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 40.85pt; text-indent: -28.35pt;\"> </p><p style=\"line-height: normal; margin: 0in 567.85pt 0.0001pt 0in;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Facilitates communication regarding patient care.</span></span></p><ol style=\"padding-left: 54.67px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Acts as a liaison with the medical staff to coordinate medical and nursing management of patient care.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Serves as resource for conflict resolution when patient issues are unresolved by primary care givers.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Presents changes and innovations in a positive manner.</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 567.85pt 0.0001pt -30pt; text-align: right;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages patient care/ Assuring Quality Discharge Planning </span></span></p><ol style=\"padding-left: 54.47px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Performance Monitoring: Analyzes patient care data and key care indicators to identify trends, reduce delays, and improve clinical outcomes.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Assures that patients have received assessment and reassessment of physical care, psychosocial support and education to be discharged safely.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Assures collaboration with appropriate other health care providers resulting in formulation of a nursing diagnosis and initiation/revision of a care plan consistent with the medical plan of care.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Actively participates in utilization management of patients across the continuum of care.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors readmissions.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors participation in Daily Discharge Rounding’s for each unit.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Coordinates interactions with other health care facilities, community agencies and the public as appropriate with regard to assigned areas of responsibility and operations.</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 567.85pt 0.0001pt -30pt; text-align: center;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Denial Management</span></span></p><ol style=\"padding-left: 54.67px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Utilizes Best Practice strategies for Denial Management.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Assumes the primary responsibility of denial management Axis program.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages in coordination with Director the appeals management process.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Serves as liaison with the finance/ billing department for claims issues.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors concurrent and retrospective denials.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Builds and maintains effective relationships with the payers.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Works collaboratively with the Physician Advisor.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Participates in the UR Committee – reporting monthly denial management activity as requested.</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages personal professional growth and development as well as the unit’s staff.</span></span></p><ol style=\"padding-left: 54.67px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Demonstrates the qualities of advocate, role model, mentor and facilitator during growth and development of self, nursing staff and other health care team members.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Delegates appropriately and provides unity of command; assists staff with delegated responsibilities.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Provides leadership, direction and remediation to unit specific nursing personnel in accordance with organizational, departmental and governing agency goals, objectives and standards.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Team Leadership: Manages, mentors, and evaluates a team of case managers and social workers to ensure high-quality care.</span></span></p></li></ol><p><strong><u>NON-ESSENTIAL FUNCTIONS</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 6pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Performs related and miscellaneous duties as assigned.</span></span></p>",
"InternalResponsibilitiesStr": "<p><strong><u>ESSENTIAL FUNCTIONS</u></strong></p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages assigned unit personnel. Provides day-to-day supervision of case management activities. </span></span></p><ol style=\"padding-left: 83.13px;\"><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Strategic Oversight: Develops and implements case management programs, including utilization review, intake, and discharge planning.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Coordinates and collaborates with staff to plan unit/ patient assignments according to staff education, training and ability, standards of care and patient needs.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Actively participates in recruiting, interviewing and selecting unit staff. Participates in and/or conducts performance reviews, as well as counseling and discipline of unit staff.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Ensures staff meet the minimum qualifications of their positions at all times including licensure, certification and registration.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Plans and evaluates work flow for continuity of patient services which assures collaboration with health care team; enhances cost management.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Actively participates in Inter Rater Reliability monitoring of staff. Performs document review of data entry for completeness, accuracy, and clarity of documentation submitted by case managers per record audit policy and procedures. Seeks corrections, completion and /or clarification from case managers and data entry when necessary, providing education/ instruction and reinforcement of policy and procedures. </span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors case management activities and time-line compliance through monitoring of case management reports and logs</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Coordinates the orientation process for new employees.</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors observation, admission, and length of stay data on a monthly basis. </span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Resource Management: Monitors departmental budgets, expenses, and the use of medical resources to enhance cost-effectiveness</span></span></p></li><li><p style=\"background-color: white; line-height: 18pt; margin-bottom: 9pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Regulatory Compliance: Ensures all practices meet federal, state, and organizational guidelines, such as Medicare/Medicaid/ Commercial requirements and JCAHO standards</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 0in 0.0001pt 40.85pt; text-indent: -28.35pt;\"> </p><p style=\"line-height: normal; margin: 0in 567.85pt 0.0001pt 0in;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Facilitates communication regarding patient care.</span></span></p><ol style=\"padding-left: 54.67px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Acts as a liaison with the medical staff to coordinate medical and nursing management of patient care.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Serves as resource for conflict resolution when patient issues are unresolved by primary care givers.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Presents changes and innovations in a positive manner.</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 567.85pt 0.0001pt -30pt; text-align: right;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages patient care/ Assuring Quality Discharge Planning </span></span></p><ol style=\"padding-left: 54.47px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Performance Monitoring: Analyzes patient care data and key care indicators to identify trends, reduce delays, and improve clinical outcomes.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Assures that patients have received assessment and reassessment of physical care, psychosocial support and education to be discharged safely.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Assures collaboration with appropriate other health care providers resulting in formulation of a nursing diagnosis and initiation/revision of a care plan consistent with the medical plan of care.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Actively participates in utilization management of patients across the continuum of care.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors readmissions.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors participation in Daily Discharge Rounding’s for each unit.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 70.35pt; margin-top: 0in; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Coordinates interactions with other health care facilities, community agencies and the public as appropriate with regard to assigned areas of responsibility and operations.</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 567.85pt 0.0001pt -30pt; text-align: center;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Denial Management</span></span></p><ol style=\"padding-left: 54.67px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Utilizes Best Practice strategies for Denial Management.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Assumes the primary responsibility of denial management Axis program.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages in coordination with Director the appeals management process.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Serves as liaison with the finance/ billing department for claims issues.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Monitors concurrent and retrospective denials.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Builds and maintains effective relationships with the payers.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Works collaboratively with the Physician Advisor.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Participates in the UR Committee – reporting monthly denial management activity as requested.</span></span></p></li></ol><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt;\"> </p><p style=\"line-height: normal; margin: 0in 70.35pt 0.0001pt -1.65pt; break-after: avoid;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Manages personal professional growth and development as well as the unit’s staff.</span></span></p><ol style=\"padding-left: 54.67px;\"><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Demonstrates the qualities of advocate, role model, mentor and facilitator during growth and development of self, nursing staff and other health care team members.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Delegates appropriately and provides unity of command; assists staff with delegated responsibilities.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Provides leadership, direction and remediation to unit specific nursing personnel in accordance with organizational, departmental and governing agency goals, objectives and standards.</span></span></p></li><li><p style=\"line-height: normal; margin-bottom: 0.0001pt; margin-right: 0in; margin-top: 0in;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Team Leadership: Manages, mentors, and evaluates a team of case managers and social workers to ensure high-quality care.</span></span></p></li></ol><p><strong><u>NON-ESSENTIAL FUNCTIONS</u></strong></p><p style=\"line-height: normal; margin: 13.45pt 6pt;\"><span style=\"color: black; font-family: inherit;\"><span style=\"font-size: 12pt;\">Performs related and miscellaneous duties as assigned.</span></span></p>",
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