RN CASE MANAGER
Not Disclosed•Full-TimeHybrid
location_onSandoval County, New Mexico, 87043, United States
About the Role
The University of New Mexico Hospital is seeking dedicated Registered Nurses to join our Care Management Department. This role is designed to bridge the gap between acute care and community living, ensuring patients receive seamless, coordinated support throughout their healthcare journey. Whether inpatient, outpatient, or in utilization management, you will serve as a vital advocate for patients from birth to end-of-life, working collaboratively with providers, therapists, pharmacists, and social workers to optimize care outcomes.
Your application may be considered for any of the following programs, and we will work with you to find the best fit for your skills and interests:
Inpatient Care Management
In this patient-facing role, you will support inpatient stays through active care coordination and discharge planning. You will work alongside a multidisciplinary team to proactively discharge patients safely to the next level of care when medically ready. This position involves daily multidisciplinary rounds and primarily in-person work, with a patient ratio of 1:25-30 across all age groups.
Outpatient Care Management
Focused on the clinic setting, this role facilitates care plans and manages the transition of care from acute settings to the home. You will assist with referrals for durable medical equipment, home healthcare, and hospice services to help patients remain at home and reduce hospital readmissions. This position involves significant collaboration with primary and specialty care providers, utilizing various software systems to manage referrals and patient data.
Utilization Management
This role ensures the medical necessity and appropriateness of patient treatments and services. You will support chart reviews for level of care, correct billing aspects, and work directly with insurance payors to handle appeals and denials. 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 Inpatient Care Management track, this position supports inpatient stays at the SRMC campus. You will be assigned to specific units, working in-person with a 1:25-30 patient ratio. You will attend daily rounds and collaborate with social work case managers, assistants, and clinical providers to ensure safe and timely discharges.
Hiring Process & Application
We are committed to finding the right fit for our team. Upon application, you may be considered for any of the programs listed above. We will engage with you to determine the best placement based on your experience and preferences.
Compensation & Benefits
- Shift Differentials: Receive 17% for weekday nights, 26% for weekend nights, and 15% for weekend day shifts.
- Sign-On Bonus: Available for qualified candidates.
- Relocation Assistance: Available for qualified candidates.
Note: Compensation is based on factors including experience, education, and organizational considerations.
Equal Opportunity Employer
The University of New Mexico Hospital is an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees and patients.
Work location
Work model: Hybrid
Sandoval County, New Mexico, 87043, United States
New Mexico
Key Responsibilities
- check_circleNavigate electronic medical record systems to send and receive patient referrals
- check_circleManage referrals for durable medical equipment, home healthcare, and hospice services
- check_circleReview patient charts to determine medical necessity and correct billing aspects of care
- check_circleCoordinate inpatient care and manage discharge planning for patients across all age groups
- check_circleCollaborate with providers, therapists, and pharmacists during daily multidisciplinary rounds
- check_circleFacilitate outpatient care plans and coordinate transitions from acute care to home settings
- check_circleCommunicate with insurance payors to handle appeals, denials, and payment recuperation
Requirements
- verifiedNursing program (nationally accredited) graduate
- verified1 year directly related experience
- verifiedRN MATRIX - Complete and maintain unit/clinic based required certifications and competencies
- verifiedCPR Certification for Healthcare/BLS Providers or for Professional Rescuers or must obtain within 30 calendar days of date of position
- verifiedLicensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico
- verifiedCAP III - Clinical Advancement Program Level III requirements satisfied
- verifiedTuberculosis testing is completed upon hire and additionally as required
Nice to Have
Bachelor's Degree of Science in Nursing. Bilingual English/Spanish. Bilingual English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo.
Benefits & Perks
check_circleShift differentials: 17% weekday nights, 26% weekend nights, 15% weekend dayscheck_circleSign-on bonus availablecheck_circleRelocation assistance availablecheck_circleWork from home option after 6 months for outpatient rolesRemote work option for Utilization Management role after orientation
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
Day-to-day, the RN CASE MANAGER at UNM Hospital will 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
UNM Hospital is looking for candidates who meet the following requirements: 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.
Where is the RN CASE MANAGER role at UNM Hospital located?expand_more
RN CASE MANAGER at UNM Hospital is based in Sandoval County, New Mexico, 87043, United States. This is a hybrid role.
Is this RN CASE MANAGER job remote, hybrid, or on-site?expand_more
UNM Hospital has listed this RN CASE MANAGER role as hybrid.
How much experience is required for this RN CASE MANAGER role?expand_more
RN CASE MANAGER at UNM Hospital typically requires 1+ years of relevant experience at the mid level level.
What skills do you need for the RN CASE MANAGER role at UNM Hospital?expand_more
Key skills for RN CASE MANAGER at UNM Hospital include Microsoft Excel; Powerchart; Cerner; Oracle; Electronic Medical Record; Electronic Faxing; Scanning; and Bilingual English/spanish.
What education is required for RN CASE MANAGER at UNM Hospital?expand_more
Educational requirements for this role: Graduate from a nationally accredited nursing program; and Bachelor's Degree of Science in Nursing preferred.
What category does the RN CASE MANAGER role belong to?expand_more
RN CASE MANAGER at UNM Hospital is part of the healthcare & nursing job category on Recrutus.