Lead Case Management RN: Care Coordination & Discharge

Artesia General Hospital; Artesia (NM); Hybrid; USD 4,811,000 - 7,624,000; Full time

Job summary

Artesia General Hospital in Artesia, NM seeks an experienced Nursing Care Coordinator to lead case management, utilization review, discharge planning, and care transitions. This leadership role emphasizes servant leadership, collaboration with physicians and nursing staff, and adherence to MCG guidelines and CMS requirements.

A Bachelor’s degree in Nursing and NM RN licensure are required, with at least five years of clinical nursing experience and three years in related leadership roles.

Qualifications

• Bachelor's degree in Nursing required.
• Active RN license in New Mexico or eligibility for licensure.
• Minimum 5 years of clinical nursing experience in an acute-care setting.
• Minimum 3 years in case management, utilization review, discharge planning, or related area.
• Minimum 2 years of leadership or supervisory experience preferred.
• Experience with MCG or comparable utilization-management criteria.
• Knowledge of CMS regulations, inpatient/observation/outpatient status requirements, and payer requirements.
• Proficiency with EHRs, utilization-review systems, data analysis, and MS Office.

Responsibilities

• Directs daily operations of case management, utilization management, discharge planning, social services, and care transitions.
• Establishes department goals, workflows, and accountability measures.
• Supervises case management and social services staff with coaching and performance evaluations.
• Ensures adequate coverage for utilization review, discharge planning, payer communication, and high-risk patient needs.
• Determines patient medical eligibility and Medicare/Managed Care eligibility for skilled services.
• Develops, reviews, and maintains departmental policies and procedures.
• Promotes effective communication and collaboration among staff, nursing, physicians, and hospital leadership.
• Assists with budgeting, staffing, productivity, and resource allocation.
• Identifies strategies to reduce inpatient length of stay and resource consumption.
• Provides patients and families with information about home health, skilled nursing facilities, rehabilitation facilities, and providers.

Skills

Servant Leadership

Excellence

Respect

Virtuousness

Innovation

Community

Education

Education

Bachelor's degree in Nursing

Job description

Artesia General Hospital in Artesia, NM seeks an experienced Nursing Care Coordinator to lead case management, utilization review, discharge planning, and care transitions. This leadership role emphasizes servant leadership, collaboration with physicians and nursing staff, and adherence to MCG guidelines and CMS requirements.

A Bachelor’s degree in Nursing and NM RN licensure are required, with at least five years of clinical nursing experience and three years in related leadership roles.