RN Case Manager - Inpatient Care Coordination

Presbyterian Healthcare Services; Rio Rancho (NM); On-site; USD 71,000 - 120,000; Full time

Benefits offered by this job

Wellness program

On-site gym access

Nutrition coaching

Mindfulness resources

Wellness challenges

Safety wearable badge

Job summary

Presbyterian Hospital—Rio Rancho is hiring an RN Case Manager to provide clinically-based case management and coordinate discharge planning, utilization management, and transitions across the continuum of care. You will work with physicians, patients, families, payers, and post-acute providers to enhance outcomes while controlling costs.

The role requires NM RN licensure, a nursing degree (BSN or higher), and relevant case management experience; certification is preferred.

Qualifications

• Bachelor's degree in nursing; 5 years utilization review or case management experience or a Master's in Nursing.
• Current State of New Mexico RN licensure required.
• 2 years adult bedside experience required.
• National Case Management certification preferred.

Responsibilities

• As an RN Case Manager, manage a designated caseload across the continuum of care.
• Coordinate utilization management and status determination with providers.
• Lead discharge planning and care transitions with post-acute services.
• Collaborate with physicians, nursing, social work, and ancillary services to optimize length of stay and patient outcomes.
• Maintain accurate, timely documentation and communicate with patients, families, and payers.

Skills

Case management

Utilization review

Discharge planning

Interdisciplinary collaboration

Education

Bachelor's degree in Nursing

Master's degree in Nursing

NM RN licensure

Job description

Location Address:

2400 Unser BlvdRio Rancho, NM 87124

Compensation Pay Range:

Minimum Offer $33.87Maximum Offer $57.68

Summary:

Make a difference. Presbyterian Hospital is hiring a RN Case Manager that will provide clinically-based case management to support the delivery of effective and efficient patient care. 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.

How you grow, learn and thrive matters here.

• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
• Malpractice liability insurance
• Loan forgiveness through the New Mexico Higher Education Department
• EPIC electronic charting system

Type of Opportunity: Full timeFTE: 1.00Job Exempt: NoWork Shift: Days (United States of America)

Responsibilities:

As an RN Case Manager, you will manage a designated caseload, collaborating with an interdisciplinary team to optimize length of stay, coordinate discharge planning, and support safe transitions across the continuum of care. You will partner with physicians, patients, families, payers, and post-acute providers to improve outcomes, enhance patient satisfaction, and reduce barriers to discharge.

Work Schedule: Days

Days 8 hour or 10 hourshifts

Presbyterian Hospital - On-Site

• Manage Patient Caseloads Across the Continuum of Care- Conduct comprehensive assessments, identify barriers to discharge, and ensure patients receive the right care at the right time from admission through transition.

• Coordinate Utilization Management and Status Determination- Apply approved clinical criteria to monitor admissions and continued stay, collaborate with providers on medical necessity documentation, and elevate cases as appropriate.

• Lead Discharge Planning and Care Transitions- Develop and coordinate individualized discharge plans, arrange post-acute services, and ensure timely, safe transitions to prevent delays and reduce readmissions.

• Collaborate with Interdisciplinary Teams- Partner with physicians, nursing, social work, and ancillary services through daily rounds, care conferences, and complex case discussions to optimize length of stay and patient outcomes.

• Drive Quality, Communication, and Documentation Excellence- Maintain accurate, timely documentation; communicate effectively with patients, families, and payers; and contribute to performance improvement and professional development initiatives.

Qualifications:

RN IMM Case Management III

• Bachelors degree in nursing plus 5 years utilization review or case management experience required; or Masters degree in Nursing.
• Current State of New Mexico Registered Nurse licensure required.
• 2 years adult bedside experience required.
• National Case Management certification preferred.

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.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system 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 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 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.

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.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services