Utilization Review & Swing Bed RN Case Manager
Portales, NM
American Traveler
5x8 hrs, Days

Assignment Overview

• Shift: Days, 5x8hrs
• Hours: 40 hrs/wk
• Start Date: Jul 13, 2026
• Length: 13 weeks
• Openings: 1

Description

American Traveler is hiring an experienced RN for a Utilization Review and Swing Bed Case Manager position in New Mexico, requiring a minimum of 5 years of experience and an active NM or Compact RN license.

Details

• Day shift position with hours from 0800–1630
• 13-week contract
• Acute care hospital setting
• Covers utilization review, discharge planning, and swing bed coordination
• Patient population includes Medicare, Medicaid, HMO, swing bed, and private insurance cases
• Involves running Interqual for all inpatient and observation patients admitted to the floor
• Participates in daily rounds with bedside staff, physicians, and ancillary team members

Requirements

• Active NM or Compact RN license currently in hand
• Minimum of 5 years of relevant RN experience required
• Experience in utilization review, discharge planning, and case management
• Knowledge of Medicare, Medicaid, HMO, swing bed, and private insurance coverage criteria
• Experience running Interqual criteria
• DOB and SSN required for consideration

Additional Information

• Responsible for evaluating and screening potential admissions to the swing bed program
• Initiates and maintains ongoing communication with patients and their families to assess discharge needs
• Collaborates with physicians to facilitate timely discharge planning and documents updates as an ongoing review
• Manages swing bed placement in collaboration with the healthcare team and completes MDS documentation as needed
• Assists with obtaining referrals and prior authorizations for Home Health Care, CME, SNF, acute rehab, and appointments
• Educates physicians and staff on appropriate level of care, utilization standards, and required documentation for admission status