Nurse Case Manager - Echo Cliffs

Tuba City Regional Health Care Corporation•Coppermine, Arizona

About The Position

The Nurse Case Manager serves as an outpatient/inpatient case manager for TCRHCC and Echo Cliffs Health Center, supporting identified high-risk patients and specialty clinics that require focused case management. The role addresses patients’ health and social needs while promoting quality, cost-effective care. It coordinates transitions from admission through discharge, continuity of care, alignment of services, and post-hospital referrals. The case manager also advises nursing, physicians, and ancillary departments on transitional and regulatory issues. The position serves culturally diverse patients who may face barriers to self-sufficiency, including illiteracy, welfare dependency, domestic violence, substance abuse, and mental health issues. Responsibilities include assessment, service planning, obtaining resources, monitoring progress, and responding to emerging needs. The Nurse Case Manager collaborates with an interdisciplinary team to assess care plans and promote safe, efficient hospitalizations; evaluates emergency department patients for medical necessity and care coordination; helps determine admission status; and develops physician-approved outpatient discharge plans. The role also coordinates care for patients with abuse, chronic pain, or frequent utilization issues and serves patients from newborn through geriatric ages.

Requirements

Associate’s or Bachelor’s Degree in Nursing.
Valid, current, full, and unrestricted Professional Nursing License to practice in a U.S. state, the Commonwealth of Puerto Rico, or a U.S. territory.
Maintain current American Heart Association Basic Life Support (BLS) certification throughout employment.
Three years of clinical nursing experience, including one year in an outpatient/inpatient setting.
Demonstrated knowledge of case management, contract health, and utilization review processes.
Satisfactory performance in prior and current employment, supported by positive references addressing working relationships, ethical standards, reliability, communication, and a team-focused approach to problem resolution.
Successful completion of job interviews, background and reference checks, fingerprint clearance, physical examinations, and other required screenings.
Submit complete and accurate employment-related documents and information.
Ability to meet the stated physical, sensory, and mental demands of the position, with reasonable accommodation where applicable.

Responsibilities

Provide comprehensive, client-centered service planning and coordination for a specified group of high-risk patients.
Manage care for prioritized TCRHCC/SPHC outpatient and inpatient patients in consultation with providers, and maintain ongoing consultation with service providers.
Collaborate with providers and other disciplines to develop and maintain a high-risk patient database and support continuity of care.
Work proactively with Utilization Review, Public Health Nursing, Patient Benefit Coordinators, and Purchased Referred Care.
Facilitate communication and coordination among healthcare team members and involve clients in decision-making.
Develop and maintain resource databases for timely, accurate patient referrals and coordinated care.
Develop care and service delivery plans with patients, families, multidisciplinary teams, and other providers based on identified needs and available provider and financial resources.
Monitor services, follow up to ensure continuity of care, update client service plans, and promote client self-advocacy and self-determination.
Prepare patients and families for discharge from case management and arrange ongoing support or direct care with discharge planners and relevant agencies.
Develop reports and performance improvement projects, and establish policies, procedures, and program objectives.
Provide case management coverage for the Adult Care Unit, Pediatric Unit, Intensive Care Unit, Obstetrics Unit, Emergency Room, and Outpatient Departments.
Serve as a resource on Advance Directives and facilitate informed choice, consent, and decision-making for patients and families.
Promote evidence-based care, as available, in conjunction with MCG Care Guidelines.
Pursue professional excellence and maintain competence in practice.
Coordinate inpatient and outpatient admissions, including obtaining beds within or outside TCRHCC/SPHC.
Collaborate with providers and nursing staff to ensure admissions occur seamlessly and without delay in patient care.
Work with providers, nursing staff, and patient benefits coordinators to ensure admission documentation and third-party referrals are complete before patients depart.
Take call on scheduled weekends as deemed necessary.
Wear required personal protective equipment while on duty and safely complete PPE donning, doffing, and disposal.
Complete training in routine cleaning and decontamination of surfaces contaminated by communicable disease.
Perform other duties as assigned.