Healthcare Clinical Case Manager

Career Land Center • Farmington, NM

1d

About The Position

A 198-bed Level III trauma center in Farmington is seeking a Clinical Access Case Manager (RN) to support hospital-wide utilization management and care coordination. The facility serves the Four Corners region and provides inpatient and outpatient services across medical, surgical, behavioral health, pediatrics, oncology, rehabilitation, and specialty care.

The role focuses on clinical access and utilization review across inpatient populations. The Case Manager applies established criteria to support appropriate admission status and level-of-care decisions, and to facilitate safe transitions throughout the patient stay. The position helps promote efficient use of hospital resources while supporting high-quality patient care.

The Case Manager works with physicians, nurses, and interdisciplinary teams throughout the facility, using InterQual criteria and Cerner-based systems to guide decision-making and documentation.

Requirements

• Associate degree in Nursing or higher.
• Minimum of 2 years of acute care experience.
• Experience with InterQual and utilization review or management.
• Basic Life Support (BLS) required upon submission.
• Active New Mexico or compact RN license required prior to start; candidates may apply without current licensure.
• Strong understanding of acute care workflows and hospital-based care coordination.

Nice To Haves

• Experience with CCM, ACM, or Milliman criteria.

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.

Benefits

• Comprehensive medical, dental, and vision coverage.
• Paid time off and holiday benefits.
• Retirement savings program.
• Continuing education and certification support.
• Opportunity to work in a hospital-wide utilization management role within a multi-service acute care facility.
• Collaborative interdisciplinary environment focused on improving patient flow and care efficiency.
• Sign-on incentive available.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree