RN CASE MANAGER
Not Disclosed•Full-TimeHybrid
location_onState Road 41, Torrance County, New Mexico, 87035, United States
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, social workers, and case management assistants. This position is primarily in-person, with most shifts running Monday through Friday from 8:00 AM to 4:30 PM. Weekend, PRN, and holiday availability are required, along with a mandatory on-call rotation of approximately 10 days per year.
Outpatient Care Management
Outpatient Case Managers facilitate care plans and manage 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. This role involves collaborating with primary and specialty care providers within the clinic setting. You will navigate multiple software systems, including PowerChart (Cerner/Oracle), Microsoft Excel, and electronic faxing tools. While clinic hours are typically 8:00 AM to 5:00 PM, the position schedule is primarily Monday through Friday with some flexibility. After six months of employment and successful completion of competency requirements, you may be eligible for one work-from-home day per week. This role does not require weekend or on-call work.
Utilization Management
This position supports the medical necessity and appropriateness of patient treatments through chart reviews, billing corrections, and direct interaction with insurance payors. You will handle provider support, appeals, and denials to ensure proper payment for patient care. This role features limited direct patient interaction and is primarily a remote work-from-home position once the onsite orientation phase is successfully completed. Most shifts are Monday through Friday from 7:00 AM to 3:30 PM, with additional weekend and PRN availability and scheduled holiday rotations. Staff may be requested to attend in-person meetings or trainings if remote work issues arise.
SRMC Care Management
Similar to the main hospital Inpatient role, SRMC Campus Case Managers support inpatient stays through care coordination and discharge planning. Assigned to specific units, you will maintain a 1:25-30 patient ratio and attend daily multidisciplinary rounds alongside the care team. This work is primarily in-person on the assigned unit. Shifts are typically Monday through Friday from 8:00 AM to 4:30 PM, with required weekend, PRN, and holiday availability, as well as an on-call rotation of approximately 10 days per year.
Hiring Process & Application
We offer competitive compensation with shift differentials (17% for weekday nights, 26% for weekend nights, and 15% for weekend days). Additional incentives include a sign-on bonus and relocation assistance. Compensation is determined by factors including experience, education, and organizational needs.
To apply, please ensure you meet the minimum qualifications, including graduation from a nationally accredited nursing program, one year of directly related experience, and a valid RN license in New Mexico. Bilingual candidates (English/Spanish or English/Native languages such as Keres, Tewa, Tiwa, Towa, Zuni, or Navajo) are highly preferred.
Equal Opportunity Employer
University of New Mexico Hospital is committed to providing a diverse and inclusive workplace. We consider qualified applicants regardless of background, race, color, religion, sex, national origin, age, disability, or veteran status.
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
In this RN CASE MANAGER at UNM Hospital role, you 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 discharge planning to ensure safe transitions to next levels of care.
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.