RN CASE MANAGER

About the Role

The RN Case Manager position within the Care Management Department at University of New Mexico Hospital offers a dynamic career path across multiple care settings. Your application may be considered for Inpatient, Outpatient, Utilization Management, or SRMC Care Management programs. We work collaboratively with candidates to identify the best fit for their skills and professional goals.

Inpatient Care Management

In this role, you will support patients throughout their hospital stay, focusing on care coordination, discharge planning, and safely transitioning patients to the next level of care when medically ready. You will work with a patient ratio of 1:25-30, serving all age groups from newborns to seniors. Your day will involve attending daily multidisciplinary rounds and collaborating closely with providers, therapists, pharmacists, and social work case managers. This position is primarily in-person and requires a commitment to comprehensive patient care from birth to end-of-life needs.

Outpatient Care Management

This role focuses on supporting patient needs within the outpatient clinic setting. You will facilitate care plans and manage the transition of care from acute hospital settings to the home environment. Key responsibilities include assisting with referrals for Durable Medical Equipment (DME), Home Healthcare, and Hospice services to help patients remain at home and reduce hospital readmissions. You will collaborate with primary and specialty care providers, navigating multiple software systems to manage referrals. While primarily computer and phone-based, this role offers a clinic environment with the potential for one work-from-home day after six months of successful employment and competency completion.

Utilization Management

In this capacity, you will support the medical necessity and appropriateness of patient treatments and services. The role involves chart reviews to determine the correct level of care, correcting billing aspects, and working directly with insurance payors to handle appeals, denials, and payment recuperation. This position offers limited patient interaction and is primarily a remote work-from-home role once the onsite orientation phase is successfully completed.

SRMC Care Management

Similar to the main hospital inpatient role, this position supports patient stays through care coordination and discharge planning. RN Case Managers are assigned to specific units, maintaining a 1:25-30 patient ratio across all age groups. You will attend daily multidisciplinary rounds and work alongside Social Work case managers, assistants, providers, therapists, and pharmacists. This work is conducted primarily in-person on the assigned unit.

Hiring Process & Application

Candidates are encouraged to apply to explore which program best aligns with their experience. The hiring process includes an onsite orientation phase, particularly for Utilization Management roles, and requires the successful completion of competency requirements and unit/clinic-based certifications. Tuberculosis testing is completed upon hire. Successful candidates may be eligible for a sign-on bonus and relocation assistance.

Equal Opportunity Employer

University of New Mexico Hospital is committed to fostering a diverse and inclusive workplace. We consider qualified applicants regardless of background, including bilingual candidates proficient in English/Spanish or regional languages such as Keres, Tewa, Tiwa, Towa, Zuni, or Navajo.