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NM - Utilization Review + Swing Bed Case Manager

NM - Utilization Review + Swing Bed Case Manager (Job ID OOJ - 8881)

Job ID

OOJ - 8881

Location

Portales, New Mexico

Remote Status

OnSite

Posted by

8 hours ago

Qualification

N/A

Job Type

Direct Client

No. Positions

10

Job Description

This position is responsible for:

  • Routine case management, discharge planning, swing bed coordinator and utilization review duties.
  • Evaluating and screening potential admissions to the facilities swing bed program
  • knowledgeable of criteria for Medicare, Medicaid, HMO, swing bed and private insurance coverage
  • Initiate ongoing communication with the resident and resident's family to assess discharge needs.
  • Actively involvement in daily rounds with bedside staff, physicians and ancillary team members
  • Communicate with physicians to ascertain their plans for a timely discharge.
  • document updates and discharge planning as an ongoing review.
  • Manage and collaborate with the healthcare team on swing bed placement and complete MDS documentation as necessary.
  • assist with obtaining referrals, prior authorization for Home Health Care, CME, SNF, acute rehab and appointments.
  • Educates physicians and staff regarding appropriate level of care/utilization and required documentation that meets admission status
  • Run Interqual for each IP and OBS patient admitted to the floor

Job Start Date: 07/13/2026

Shift Information: 0800-1630

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