MINIMUM QUALIFICATIONS:

EDUCATION: Graduate of an approved school of nursing, BSN preferred.

CERTIFICATION/LICENSES: Current licensure as an RN in New Mexico mandatory.

SKILLS: Excellent reading, writing, and editing skills in English. Strong organizational skills. Knowledge of or ability to learn Milliman® and Interqual® criteria. Ability to effectively evaluate physician orders and medical records. Competent computer skills for word processing, data collection, and retrieval. Ability to analyze and create reports.

EXPERIENCE: Minimum of five years of experience in a health care setting, of which a minimum of two years has been spent in an acute care setting. Experience with utilization management, knowledge of Milliman ®and Interqual® criteria, managed care language, and CMS rules and regulations preferred.

NATURE OF SUPERVISION:

-Responsible to: Manager of Case Management

ENVIRONMENT: Blood borne Pathogens: A

Office setting. Rotating shifts and weekends when necessary. Must be able to adjust to frequently changing workloads and frequent interruptions.

PHYSICAL REQUIREMENTS:

Ability to move around the hospital to all units/departments for about 10% of the day, in office 90% of the day. Requires close work, good vision, dexterity to write as well as to use computer keyboard. May be required to lift, push, pull and/or carry up to 25 lbs.