Case Manager

RN Case Manager

The RN Case Manager role is available in the Care Management Department at the University of New Mexico Hospital in Albuquerque. This position can be in either Inpatient or Outpatient Care Management, or Utilization Management. The role offers flexibility with full-time and part-time options, and includes various shift differentials.

Inpatient Care Management:

• Supports patients through care coordination, discharge planning, and ensuring safe transitions to the next level of care.
• RN Case Managers have a 1:25-30 patient ratio and support all age groups.
• Attend daily multidisciplinary rounds and work alongside providers, therapists, and pharmacists.
• Most positions are Monday-Friday from 8-4:30pm.
• Requires on-call for weekends (10 days/year) and holiday coverage (2 Holidays/year).

Outpatient Care Management:

• Supports patient needs in the outpatient clinic setting, facilitating care plans and coordinating transitions of care.
• Assists with referrals for Durable Medical Equipment, Home Healthcare, Hospice, and other care coordination needs.
• Collaborates with primary and specialty care providers within the clinic setting.
• Primarily works on computer and phone, navigating multiple software systems.
• Clinic hours are normally 8:00am-5:00pm.
• Position schedule is primarily Monday-Friday from 8:00am-4:30pm with some flexibility.
• Primarily works in the clinic setting with one work from home day after 6 months of employment and successful completion of competency requirements.
• No weekends or on-call work requirement.
• Clinics are closed on major holidays.

Utilization Management:

• Supports the medical necessity and appropriateness for all patients receiving treatment/services.
• Provides provider support, appeals, and denials, and works directly with insurance payors.
• Primarily a remote work from home position once orientation is completed.
• Most positions are Monday-Friday from 7:00am-3:30pm.
• Additional weekend positions and PRN availability.
• Scheduled holiday rotations.
• Staff can be requested to attend in-person meetings or trainings if remote work issues arise.

Inpatient Care Management - SRMC Campus:

• Supports patients through care coordination, discharge planning, and ensuring safe transitions to the next level of care.
• RN Case Managers have a 1:25-30 patient ratio and support all age groups.
• Attend daily multidisciplinary rounds and work alongside Social Work case managers, case management assistants, providers, therapists, and pharmacists.
• Most positions are Monday-Friday from 8-4:30pm.
• Requires on-call for evenings and weekends (approximately 10 days/year) and holiday coverage (approximately 2 Holidays/year).

Minimum Qualifications:

• Education: Nursing program (nationally accredited) graduate.
• Experience: 1 year directly related experience.
• Certifications: RN MATRIX - Complete and maintain unit/clinic based required certifications and competencies as listed in the department expectations/and or the unit/clinic education matrix.
• Licenses/Certifications: 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.
• Testing Requirements: Tuberculosis testing is completed upon hire and additionally as required.

Preferred Qualifications:

• Preferred Education: Bachelor's Degree of Science in Nursing.
• Preferred Experience: Bilingual English/Spanish, Bilingual English/Keres Tewa Tiwa Towa Zuni or Navajo.