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 opportunity to support patients across the continuum of care. Your application may be considered for any of the following programs: Inpatient, Outpatient, Utilization Management, or SRMC Care Management. 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 during their hospital stay through care coordination and discharge planning. The goal is to proactively discharge patients safely to the next level of care once they are medically ready. You will work with a patient ratio of 1:25-30, supporting all age groups from newborns to seniors. Your day will involve attending daily multidisciplinary rounds and collaborating closely with providers, therapists, and pharmacists. This work is primarily performed in person on assigned units.

Outpatient Care Management

Here, you will support patient needs within the outpatient clinic setting, focusing on care plan facilitation and coordinating the transition of care from acute settings to the home. You will assist with referrals for Durable Medical Equipment (DME), Home Healthcare, and Hospice 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 working in a clinic setting, there is an opportunity for one work-from-home day after six months of employment and successful completion of competency requirements.

Utilization Management

This role supports the medical necessity and appropriateness of treatment services for all patients. You will perform chart reviews to determine the level of care, correct billing aspects, and provide provider support regarding appeals and denials. You will work directly with insurance payors to recuperate payment for patient care. 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

Similar to the main campus Inpatient role, this position supports patient stays through care coordination and discharge planning. You will be assigned to specific units, maintaining a 1:25-30 patient ratio and supporting all age groups. You will attend daily multidisciplinary rounds alongside social work case managers, case management assistants, providers, therapists, and pharmacists. This work is performed primarily in person on the assigned unit.

Hiring Process & Application

Candidates who meet the minimum qualifications will be considered for these roles. The hiring process includes an onsite orientation phase, particularly for Utilization Management positions, and requires the successful completion of competency requirements and unit/clinic-based certifications. Tuberculosis testing is completed upon hire.

Compensation & Benefits

Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations. Shift differentials are available: 17% for weekday nights, 26% for weekend nights, and 15% for weekend days. A sign-on bonus and relocation assistance are available for qualified candidates.

Equal Opportunity Employer

University of New Mexico Hospital is an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. Bilingual candidates (English/Spanish or English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo) are preferred.