RN Case Manager

AccessHealth; Albuquerque (NM); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Sign-on bonus

Relocation assistance

Job summary

AccessHealth in Albuquerque, NM seeks a Registered Nurse Case Manager to support care management across inpatient, outpatient, and utilization management services. You will coordinate patient care from admission through discharge, develop care plans, and facilitate transitions to reduce readmissions.

The role involves collaboration with providers, therapists, pharmacists, and social workers, both in person and remotely, using EMR systems.

Qualifications

• Graduate of an accredited nursing program.
• Minimum of 1 year of relevant experience.
• Current RN license in the state of practice.
• CPR/BLS certification within 30 days of hire.
• Completion of required certifications and competencies.

Responsibilities

• Coordination of patient care during inpatient stays through discharge planning and safe transition to next care levels.
• Support outpatient patients by facilitating care plans, referrals, and transition of care to reduce readmissions.
• Assist with utilization management by reviewing medical necessity, performing chart reviews, and liaising with insurance payors for billing and denials.
• Work collaboratively with multidisciplinary teams, including providers, therapists, pharmacists, and social workers.
• Perform in-person and remote work, utilizing electronic medical records and communication systems.

Skills

Care coordination

Clinical assessment

Utilization management

Interdisciplinary collaboration

EMR proficiency

Education

Bachelor’s degree in Nursing

RN license in state of practice

CPR/BLS certification

Job description

We are seeking a Registered Nurse (RN) Case Manager to join our Care Management Department, supporting inpatient, outpatient, and utilization management services.

Key Responsibilities Include

• Coordination of patient care during inpatient stays through discharge planning and safe transition to next care levels.
• Support outpatient patients by facilitating care plans, referrals, and transition of care to reduce readmissions.
• Assist with utilization management by reviewing medical necessity, performing chart reviews, and liaising with insurance payors for billing and denials.
• Work collaboratively with multidisciplinary teams, including providers, therapists, pharmacists, and social workers.
• Perform in-person and remote work, utilizing electronic medical records and communication systems.

Qualifications Include

• Graduate of an accredited nursing program.
• Minimum of 1 year of relevant experience.
• Current RN license in the state of practice.
• CPR/BLS certification within 30 days of hire.
• Completion of required certifications and competencies.

Preferred Qualifications

• Bachelor’s Degree in Nursing.
• Bilingual in English and Spanish or other languages such as Keres, Tewa, Tiwa, Towa, Zuni, or Navajo.

The role involves working primarily Monday-Friday with opportunities for weekend, PRN, and on-call shifts, including holiday coverage. It offers competitive compensation, shift differentials, and benefits such as sign-on bonus and relocation assistance.