RN Clinical Access & Utilization Manager

Career Land Center, LLC; Farmington (NM); On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Sign-on incentive

Job summary

Career Land Center, LLC in Farmington seeks a Clinical Access Case Manager (RN) to support hospital-wide utilization management and care coordination at a 198-bed Level III trauma center serving the Four Corners region. The role applies InterQual criteria and Cerner-based systems to guide admission status, level-of-care determinations, and safe transitions.

Collaborating with physicians, nurses, and multidisciplinary teams, you will optimize patient flow, resource use, and ensure high-quality

Qualifications

• Associate degree in Nursing or higher required.
• Minimum of 2 years of acute care experience required.
• Experience with InterQual and utilization review/management required.
• Experience with CCM, ACM, or Milliman criteria preferred.
• Basic Life Support (BLS) required upon submission.
• Active New Mexico or compact RN license required prior to start.
• Strong understanding of acute care workflows and hospital-based care coordination.

Responsibilities

• Perform utilization review and clinical access evaluations for inpatient admissions
• Apply InterQual criteria to support level-of-care determinations
• Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate patient placement
• Support timely and appropriate care transitions across the continuum
• Identify opportunities to improve utilization, throughput, and resource management
• Document clinical reviews and care decisions accurately within Cerner systems
• Communicate findings and recommendations clearly to clinical teams
• Support compliance with regulatory and payer requirements related to utilization management
• Assist with coordination of patient flow across hospital departments

Skills

InterQual criteria experience

Utilization review

Care coordination

Acute care workflow knowledge

Education

Associate degree in Nursing or higher

Tools

Cerner systems

Milliman CCM/ ACM criteria

InterQual criteria software

Job description

Career Land Center, LLC in Farmington seeks a Clinical Access Case Manager (RN) to support hospital-wide utilization management and care coordination at a 198-bed Level III trauma center serving the Four Corners region. The role applies InterQual criteria and Cerner-based systems to guide admission status, level-of-care determinations, and safe transitions.

Collaborating with physicians, nurses, and multidisciplinary teams, you will optimize patient flow, resource use, and ensure high-quality