RN Care Manager

The VIOS Clinic; Albuquerque (NM); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Sign-on bonus

Relocation assistance

Flexible scheduling

Job summary

The VIOS Clinic is seeking a Registered Nurse (RN) Case Manager to coordinate care for both inpatient and outpatient settings, support utilization review, and assist with discharge planning. The role requires strong communication and EMR proficiency, with flexibility to work in person for inpatient duties and remotely for utilization management.

Ideal candidates have an active NM RN license, CPR/BLS certification, and at least 1 year of relevant experience; bilingual English/Spanish is a plus.

Qualifications

• Graduation from an accredited nursing program.
• At least 1 year of relevant experience.
• Current RN license in NM; CPR/BLS and required departmental certifications.
• Preferred: Bachelor's Degree in Nursing and bilingual English/Spanish.

Responsibilities

• Coordinate care for inpatients through rounds and discharge planning.
• Assist outpatient clients with care transitions, referrals, and services like DME, home health, and hospice.
• Support utilization management by reviewing cases for medical necessity and working with payors.
• Collaborate with clinicians, therapists, pharmacists, and social workers in clinical and remote settings.

Skills

Care coordination

Communication

EMR proficiency

Spanish bilingual

Education

Bachelor's Degree in Nursing

RN license in NM

Tools

EMR software

Job description

We are seeking a Registered Nurse (RN) Case Manager to support inpatient and outpatient care management, utilization review, and discharge planning.

Key Responsibilities Include

• Providing care coordination for inpatient stays, supporting patients of all ages through multidisciplinary rounds and discharge planning.
• Assisting outpatient clients with care transitions, referrals, and support for services like DME, home healthcare, and hospice.
• Supporting utilization management by reviewing cases for medical necessity, handling appeals, denials, and working with insurance payors.
• Collaborating with healthcare providers, therapists, pharmacists, and social workers in both clinical and remote settings.

Qualifications Include

• Graduation from an accredited nursing program.
• At least 1 year of relevant experience.
• Current RN license in the state, CPR/BLS certification, and required departmental certifications.
• Preferred: Bachelor's Degree in Nursing and bilingual skills in English and Spanish or local indigenous languages.

Skills And Conditions

• Strong communication, computer proficiency (Microsoft Office, electronic medical records), and care coordination skills.
• Ability to work primarily in person for inpatient roles and remotely for utilization management roles.
• Availability for weekend, holiday, and on-call coverage as needed.

This role offers additional benefits such as sign-on bonus, relocation assistance, and flexible scheduling.