RN Case Manager - Inpatient Care Coordination

Capital Markets Placement; New Mexico; On-site; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking an RN Case Manager specializing in inpatient care coordination. The role involves managing patient care through utilization review and collaboration with healthcare teams to enhance patient outcomes. The ideal candidate will possess an RN license and relevant experience in case management.

Benefits

Sign on and relocation bonuses

Tuition and certification reimbursement

Wellness program access

Malpractice liability insurance

Loan forgiveness program

Qualifications

• Registered Nurse with relevant clinical practice experience.
• National Case Management certification preferred.
• Experience in utilization review or case management recommended.

Responsibilities

• Provide case management within the Emergency Department, focusing on patient care and outcomes.
• Coordinate discharge plans and facilitate communication with interdisciplinary teams.
• Monitor length of stay and quality of care to prevent readmissions.

Skills

Utilization Management

Care Coordination

Patient Assessment

Communication

Education

Associate Degree in Nursing

Registered Nurse - State of New Mexico or Compact State Nursing License

National Case Management certification

Job description

RN Case Manager - Inpatient Care Coordination

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RN Case Manager - Inpatient Care Coordination

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Overview: Presbyterian is seeking a RN Case Manager that will provide clinically-based case management to support the delivery of effective and efficient patient care based in the Emergency Department by completing Utilization Review for Level of Care and Initial Assessments.

The role integrates utilization management, care coordination, and transition planning functions. The Case Manager has the overall accountability for a designated case load and plans effectively in order to meet patients needs, manage the length of stay, and promote efficient utilization of resources. In collaboration with the interdisciplinary team, the case manager supports the physician in facilitating patient care with the objective of enhancing the quality of patient outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers.

Sign on and relocation bonuses available for qualified candidates.

How You Grow, Learn And Thrive Matters Here.

• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Wearable alarm badge (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Shift differentials for nights and weekends
• Differentials for higher education, certifications and various lead roles
• Malpractice liability insurance
• Loan forgiveness through the New Mexico Higher Education Department
• EPIC electronic charting system
  
  

Type of Opportunity: Full Time

FTE: 1.000000

Exempt: No

Work Schedule: 8 or 10 hour shifts - Days or Nights available

Qualifications: RN-Case Management I:

• Associate Degree in Nursing
• Registered Nurse - State of New Mexico or Compact State Nursing License required.
• National Case Management certification preferred
• Two years clinical nursing experience in relevant clinical practice area with utilization review or case management experience preferred.
  
  

RN-Case Management II:

• Registered Nurse with Bachelors of Science in nursing (BSN) degree or Registered Nurse with Associates degree in nursing (ADN) plus five years utilization review or case management experience required.
• Registered Nurse - State of New Mexico or Compact State Nursing License required
• National Case Management certification preferred
• Two years clinical nursing experience in relevant clinical practice area with utilization review or case management experience preferred.
  
  

RN-Case Management III:

• Registered Nurse with Masters of Science in nursing (MSN) degree or Registered Nurse with Bachelors in nursing (BSN) plus five years utilization review or case management experience required.
• Registered Nurse - State of New Mexico or Compact State Nursing License required.
• National Case Management certification preferred
• Two years clinical nursing experience in relevant clinical practice area with utilization review or case management experience preferred.
  
  

RN-Case Management IV:

• Registered Nurse with Masters of Science in nursing (MSN) degree plus five years utilization review or case management experience or Registered Nurse with Bachelors in nursing (BSN) plus ten years utilization review or case management experience required.
• Registered Nurse - State of New Mexico or Compact State Nursing License required.
• National Case Management certification preferred
• Two years clinical nursing experience in relevant clinical practice area with utilization review or case management experience preferred.
  
  

Responsibilities:

• Interviews and assesses each patient, family or other designated person(s) within 48 hours of admission in order to obtain financial, emotional, physical, social, functional and health care needs in order to define and recommend potential discharge plans, manage patient and family expectations, identify readmission risk and target interventions to reduce risk for readmission, and identify, adjust and manage barriers to discharge.
• Applies approved clinical criteria to monitor appropriateness of admissions and continued stays to ensure a clear status determination. Refers cases and issues to Case Management Medical Director based on departmental standards.
• Demonstrates skill in communicating with physicians the necessary documentation required to demonstrate medical necessity. Elevates to Supervisor and/or Medical Director all patients not meeting criteria after discussion with physician.
• Demonstrates skill in educating patient, family and interdisciplinary team regarding post-acute care options, status determination, and other care coordination services.
• Develops implements, coordinates, monitors and evaluates preliminary and final discharge plans with the interdisciplinary team, patient and family. Arranges and/or facilitates identified discharge needs and services of patients and ensures timely intervention to prevent delays in service and transition of care. Ensures all elements of the plan of care have been communicated to the patient/family and members of the healthcare team to assure continuity of care.
• Participates and facilitates care progression in daily multidisciplinary rounds and addresses target length of stay with health care providers to achieve complete delivery of services within prescribed timeframe. Monitors length of stay and takes action to mitigate overutilization and elevates to medical director as needed.
• Presents and actively participates in complex rounds, discharge planning huddles, process improvement teams, department specific initiatives and department meetings.
• Identifies patients and families with complex psychosocial issues and refers them to the Social Worker as appropriate. Demonstrates skill and success in collaboration with Social Work partner.
• Facilitates and leads patient/family and provider care conferences as needed.
• Documents results of assessments, status assignment, and interventions and discharge planning in the medical record according to departmental policies and procedures.
• Ensures safe care to patients adhering to policies, procedures, and standards within budgetary specifications, including time management, supply management, productivity and accuracy of practice.
• Promotes individual and departmental professional growth and development by meeting requirements for and facilitating continuing education, skills competency. Supports departmental based goals which contribute to the success of the organization. Serves as a mentor, preceptor, mentor and resource to less experienced staff.
  
  

Benefits: Benefits

We're All About Well-being, Starting With Yours.

Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn More About Our Employee Benefits.

Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.

Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to: USD $51.41/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Staffing and Recruiting

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