Rn, Registered Nurse Clinical Care Coordinator - Case Management
Company: Christus Health
Location: Santa Fe
Posted on: March 27, 2026
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Job Description:
Description Summary: The Registered Nurse Clinical Care
Coordinator is responsible for establishing, coordinating, and
maintaining the process to increase patient throughput to the most
appropriate level of care while facilitating interdisciplinary care
across the continuum for the ED. The RN Clinical Care Coordinator
collaborates with the patient and/or family, multidisciplinary
team, physicians, community partners, and payers to ensure the
patient’s progress and level of care are appropriately determined
and evaluates or screens patients entering the CHRISTUS Health
System for medical necessity. The RN Clinical Care Coordinator will
collaborate with relevant providers and partners to determine the
appropriate patient class and level of care of patients entering
the CHRISTUS Health system to ensure the appropriate utilization of
resources and maximize appropriate reimbursement opportunities. The
RN Clinical Care Coordinator will utilize problem-solving and
customer service skills to determine the best course of action for
the patient, the physician, and the hospital by working closely
with facility House Supervisors, referring physicians, ED, and
inpatient staff to ensure the effective and efficient
admission/placement of every patient. This job requires the full
understanding and active participation in fulfilling the Mission of
CHRISTUS Health. It is expected that the associate demonstrates
behavior consistent with the Core Values. The associate shall
support CHRISTUS Health’s strategic plan and the goals and
direction of their Performance Improvement Plan (PIP).
Responsibilities: Meets expectations of the applicable OneCHRISTUS
Competencies: Leader of Self, Leader of Others, or Leader of
Leaders. Reviews clinical information for patients upon entry into
the health system to determine appropriate placement and patient
class to maximize appropriate hospital reimbursement and positively
manage length of stay. Coordinates with onsite partner providers
(LTACH, Inpt Rehab) to review requests for facility services and
ensure appropriate use of outpatient hospital resources for (their
patients) including scheduling coordination and appropriate escort
by sending provider. Review all ED patients identified by the
treating physician as requiring admission to the hospital to ensure
appropriate patient class and resource utilization. Educates
hospital and ED providers on levels of care, resource utilization,
payor practices, and documentation. Escalates to Physician Advisor
or CMO when discrepancies are present. Performs the initial
clinical medical necessity review utilizing evidence-based criteria
and enters into the medical record for the receiving CM team.
Utilizes high risk screening criteria to make appropriate community
and post-ED referrals. Initiates prior authorization process when
indicated for post-ED referrals and services. Escalates to
physician advisor when unable to resolve discrepancies with the
attending physician. Manages high-use patients and works to find
alternatives for care to frequent ED visits. Plans for discharges
from the ED for patients who do not require admission to include
arranging for Home Health, DME, placement, and community resources
as they relate to social determinants of health. Provides patient
and family education and counseling about existing health problem
related care. Anticipates barriers/variances to the delivery of
care and intervenes as necessary. Intervenes with physicians and
ancillary departments concerning clinical and utilization issues to
ensure optimal patient outcomes. Coordinates and facilitates
patient progression throughout the continuum. Collaborates with all
members of the interdisciplinary team to facilitate appropriate
care coordination and care delivery. Job Requirements:
Education/Skills Graduate of an accredited school of nursing
required Experience 2 years of experience in Case Management and/or
Utilization Management required Licenses, Registrations, or
Certifications RN License in the state of employment required BLS
required Work Schedule: MULTIPLE SHIFTS AVAILABLE Work Type: Part
Time
Keywords: Christus Health, Santa Fe , Rn, Registered Nurse Clinical Care Coordinator - Case Management, Healthcare , Santa Fe, New Mexico
