Inpatient Case Manager – Acute Observation

PHP Administrative; Albuquerque (NM); On-site; USD 66,000 - 112,000; Full time

Benefits offered by this job

Tuition reimbursement

Scholarship opportunities

Staff safety badge

Malpractice insurance

Loan forgiveness

Well-being program

Job summary

Presbyterian Healthcare Services in Albuquerque, NM is seeking an experienced Case Manager/Nurse to apply established utilization review processes and coordinate patient care across the continuum. This role emphasizes assessment, care planning, discharge coordination and collaboration with the Presbyterian Integrated Care Management program.

The position requires a BSN, RN license, and at least five years of clinical nursing with case management experience, plus strong computer skills and

Qualifications

• Bachelor's degree in Nursing is required and RN licensure is mandatory.
• Minimum five years in relevant clinical nursing with case management experience.
• At least two years in inpatient adult, NICU, ICU or Medical-Surgical settings.
• National Case Management certification preferred within 3 years of hire.
• Proficient in Windows, Word, Excel and database systems.

Responsibilities

• Receives, reviews, verifies and processes pre-service and concurrent service approvals.
• Identifies and advocates for members, coordinating inpatient, outpatient and community resources.
• Performs in-depth psychosocial, medical, environmental and financial assessments.
• Collaborates to develop, implement and document treatment and discharge plans.
• Applies utilization criteria to assess admission and level of care; notifies Physician Advisor when needed.
• Educates providers and departments on health management strategies and care coordination.
• Meets turnaround times for prior authorizations and concurrent reviews.

Skills

RN license

Bachelor's degree in Nursing

Case management experience

Utilization review

Electronic health records

Education

Bachelor of Science in Nursing

Tools

Windows

Microsoft Word

Microsoft Excel

EPIC (Electronic Health Records)

Job description

Presbyterian Healthcare Services in Albuquerque, NM is seeking an experienced Case Manager/Nurse to apply established utilization review processes and coordinate patient care across the continuum. This role emphasizes assessment, care planning, discharge coordination and collaboration with the Presbyterian Integrated Care Management program.

The position requires a BSN, RN license, and at least five years of clinical nursing with case management experience, plus strong computer skills and