RN CASE MANAGER
Not Disclosed•Full-TimeHybrid
location_on100, Fire Station Road, Valencia, Los Lunas, Valencia County, New Mexico, 87031, United States
About the Role
The University of New Mexico Hospital is seeking dedicated Registered Nurses to join our Care Management Department. This position offers a unique opportunity to shape patient outcomes across a continuum of care, from inpatient stays to outpatient transitions and utilization management. Your application may be considered for any of our programs, and we will work with you to find the best fit for your skills and interests.
Inpatient Care Management
In this role, you will support patients throughout their hospital stay, focusing on care coordination and discharge planning. You will work to proactively move patients safely to the next level of care as soon as they are medically ready. You will manage a patient ratio of 1:25-30, supporting individuals from newborns to seniors. Your day will involve attending daily multidisciplinary rounds and collaborating closely with providers, therapists, pharmacists, and social workers. This work is primarily performed in person on assigned units.
Outpatient Care Management
Here, you will support patient needs within the clinic setting, facilitating care plans and coordinating transitions from acute care to home. You will assist with referrals for durable medical equipment, home healthcare, and hospice services, helping patients remain at home and reducing 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 flexible schedule and the potential for one work-from-home day after six months of successful employment and competency completion.
Utilization Management
This role focuses on supporting the medical necessity and appropriateness of patient treatments. You will conduct chart reviews to ensure the correct level of care, address billing aspects, and work directly with insurance payors to handle appeals and denials. This position involves limited patient interaction and is primarily a remote work-from-home role once the onsite orientation phase is successfully completed.
SRMC Care Management
On the SRMC campus, you will perform similar inpatient care coordination duties, supporting patients across all age groups. You will be assigned to specific units, managing a 1:25-30 patient ratio and attending daily multidisciplinary rounds alongside social work case managers, assistants, providers, and pharmacists. This work is conducted primarily in person on your assigned unit.
Hiring Process & Application
Candidates must complete a nationally accredited nursing program and hold a valid Registered Nurse license in the State of New Mexico. Successful applicants will also need to obtain CPR/BLS certification within 30 days of hire and complete required tuberculosis testing. We offer a competitive compensation package including shift differentials, sign-on bonuses, and relocation assistance for qualified candidates.
Similar Job Opportunities
Skills, education and keywords
Skills: Microsoft Excel, Powerchart, Cerner, Oracle, Electronic Medical Record, Electronic Faxing, Scanning, Bilingual English/spanish, Bilingual English/keres, Bilingual English/te Wa.
Education: Graduate from a nationally accredited nursing program; Bachelor's Degree of Science in Nursing (Preferred).
Frequently asked questions about RN CASE MANAGER at UNM Hospital
What does a RN CASE MANAGER at UNM Hospital do?expand_more
A RN CASE MANAGER at UNM Hospital is responsible for the following: Navigate electronic medical record systems to send and receive patient referrals; Manage referrals for durable medical equipment, home healthcare, and hospice services; Review patient charts to determine medical necessity and correct billing aspects of care; and Coordinate inpatient care and manage discharge planning for patients across all age groups.
What are the requirements for this RN CASE MANAGER role?expand_more
To qualify for the RN CASE MANAGER at UNM Hospital position, applicants should have: Nursing program (nationally accredited) graduate; 1 year directly related experience; RN MATRIX - Complete and maintain unit/clinic based required certifications and competencies; CPR Certification for Healthcare/BLS Providers or for Professional Rescuers or must obtain within 30 calendar days of date of position; Licensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico; and CAP III - Clinical Advancement Program Level III requirements satisfied.