RN CASE MANAGER -

UNM Sandoval Regional Medical Center; Albuquerque (NM); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Sign-On Bonus Available

Relocation Assistance Available

Job summary

UNM Sandoval Regional Medical Center in Albuquerque is hiring an RN Case Manager to support patient care through coordination and discharge planning across inpatient and outpatient settings. The ideal candidate will possess a Bachelor's Degree in Nursing, a valid RN license in New Mexico, and at least one year of related experience.

This role offers opportunities for weekend and PRN availability along with sign-on bonuses and relocation assistance. Bilingual candidates are preferred.

Qualifications

• 1 year directly related experience required.
• Licensed Registered Nurse (RN) in State of New Mexico.
• CPR Certification for Healthcare/BLS Providers must be obtained within 30 days.

Responsibilities

• Support patient’s inpatient stay through care coordination and discharge planning.
• Collaborate with providers in outpatient settings.
• Ensure medical necessity appropriateness for patients receiving services.

Skills

Bilingual English/Spanish

Patient Care Coordination

Care Planning

Utilization Management

Education

Bachelor's Degree of Science in Nursing

Graduate from accredited Nursing program

Tools

Microsoft Excel

Microsoft Word

PowerChart – Cerner/Oracle electronic medical record

Job description

Preferred Experience

Bilingual English/Spanish

RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque

• Inpatient
• Outpatient
• Utilization Management
• SRMC Care Management
• Full Time
• Part Time

Compensation

Receive 17% Weekday Nights, 26% Weekend Nights and 15% Weekend Day shift differentials.

Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.

Care Management Department Descriptions

Your application may be considered for any of the below programs. We will work with you to find the best fit.

Inpatient Care Management

Supports patient's inpatient stay through care coordination, discharge planning and proactively discharging patient safely to the next level of care when medically ready. RN Case Managers have a 1:25‑30 patient ratio and support all age groups from newborn to seniors. From birth to end‑of‑life needs. RN CM attend daily multidisciplinary rounds and work alongside providers, therapist, pharmacist on a daily basis. This work is done primarily in person.

• Most positions will be Monday‑Friday from 8‑4:30 pm.
• Weekend and PRN availability.
• There is required on‑call for weekends (10 days/year).
• Holiday coverage (2 Holidays/year).

Outpatient Care Management

Supports patient needs in the outpatient clinic setting, that encompasses care plan facilitation, transition of care coordination between an acute care setting to the home. RN Case Manager (RNCM) will assist with referrals in the areas of Durable Medical Equipment (DME) support, Home Healthcare, Hospice, and any other care coordination needs that helps patients continue to stay at home and reduce readmission to the hospital.

RN CM work collaboratively with primary and specialty care providers within clinic setting. Ratios vary depending on clinic site but can vary depending on whether it is a specialty clinic versus a primary care clinic.

• Primarily working on computer and phone, navigating multiple software systems/programs to send and receive referrals for patients.
• Microsoft Excel and Word.
• PowerChart – Cerner/Oracle electronic medical record.
• Electronic faxing/scanning system.
• Clinic hours are normally 8:00‑17:00.
• Position schedule primarily Monday‑Friday 8:00‑16:30, with some flexibility.
• Primarily work in clinic setting with consideration for 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 appropriateness for all patients receiving treatment/services. This is supported by a chart review for the level of care and correcting billing aspects of care for our patients while they are hospitalized. They provide provider support, appeals and denials and work directly with insurance payors to recuperate payment for patient care. There is limited patient interaction.

• Primarily a remote work from home position once applicant has successfully completed the onsite orientation phase.
• Most positions are Monday‑Friday 7‑3:30, with additional weekend positions and prn availability. Scheduled Holiday rotations.
• Staff can be requested to attend in‑person meetings, trainings or come into the work environment if any remote work issues arise.

Inpatient Care Management – SRMC Campus

Supports patient’s inpatient stay through care coordination, discharge planning and proactively discharging patient safely to the next level of care when medically ready. RN Case Managers are assigned to units and have a 1:25‑30 patient ratio and support for all age groups. RN CM attends daily multidisciplinary rounds and works alongside Social Work case manager, case management assistants, providers, therapist, and pharmacist daily. This work is done primarily in person on their assigned unit/s.

• Most positions will be Monday‑Friday from 8‑4:30 pm.
• Weekend and PRN availability.
• There is required on‑call for evenings and weekends (approximately 10 days/year).
• Holiday coverage (approximately 2 Holidays/year).

Education

Minimum qualifications: 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.
• 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.
• CAP III – Clinical Advancement Program Level III requirements satisfied.

Testing Requirements

Tuberculosis testing is completed upon hire and additionally as required.

Preferred Qualifications

• Bachelor's Degree of Science in Nursing.
• Bilingual English/Spanish.
• Bilingual English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo.
• Sign‑On Bonus Available.
• Relocation Assistance Available.