RN Case Manager - Inpatient Care Coordination
About The Position
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.
Requirements
- RN IMM Case Management I Associates Degree in nursing required. BSN within 5 years of hire date.
- Current State of New Mexico Registered Nurse licensure required.
- 2 years clinical nursing experience in relevant clinical practice area with utilization review or case management experience desirable.
- RN IMM 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.
- BSN to be obtained within 5 years of hire date.
- Current State of New Mexico Registered Nurse licensure required.
- 2 years clinical nursing experience in relevant clinical practice area required.
- 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 clinical nursing experience in relevant clinical practice area required.
- RN IMM Case Management IV Masters degree in nursing plus 5 years utilization review or case management experience required; or Bachelors degree in nursing plus 10 years utilization review or case management experience required.
- Current State of New Mexico Registered Nurse licensure required.
- 2 years clinical nursing experience in relevant clinical practice area required.
Nice To Haves
- National Case Management certification preferred
Responsibilities
- 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 escalate 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.
Benefits
- 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
- free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more
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What This Job Offers
Career Level
Mid Level
Education Level
Associate degree
