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Utilization Management Case Manager Rn Jobs in Las Cruces, NM

A24Group

Director of Case Management FT

Las Cruces, NM · On-site

... RN licence in New Mexico or valid compact licence * ★ Minimum three years of utilization management and case management experience * ★ Minimum two years of leadership experience in a healthcare ...

ScionHealth

Case Manager II Full Time

El Paso, TX · On-site

... of functions of case management, utilization review and management, and discharge planning ... BSN, MSN, BSW or MSW (Preferred) Licenses/Certifications * RN - Registered Nurse - State Licensure ...

Genex

Bilingual Nurse Case Manager (RN)

Las Cruces, NM · On-site

... case management process. Works as an intermediary between carriers, attorneys, medical care ... Main responsibilities will include but are not limited to: • Uses clinical/nursing skills to help ...

ScionHealth

Case Manager I PRN

El Paso, TX · On-site

Graduate of an accredited program required: LPN/LVN or RN. * Master of Social Work with licensure ... Experience in case management, utilization review, or discharge planning a plus.

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Utilization Management Case Manager Rn information

See Las Cruces, NM salary details

$19

$47

$79

How much do utilization management case manager rn jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for utilization management case manager rn in Las Cruces, NM is $47.02, according to ZipRecruiter salary data. Most workers in this role earn between $34.95 and $56.83 per hour, depending on experience, location, and employer.

What is the difference between Utilization Management Case Manager Rn vs Utilization Review Nurse?

AspectUtilization Management Case Manager RnUtilization Review Nurse
CredentialsRN license, certification in case management (e.g., CCM)RN license, often with certification in utilization review
Work EnvironmentInsurance companies, healthcare facilities, case management teamsHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing cases, ensuring appropriate utilizationReviewing medical necessity, approving or denying services
Common TasksAssessing patient needs, developing care plans, liaising with providersEvaluating medical records, making utilization decisions, ensuring compliance

The main difference is that the Utilization Management Case Manager Rn focuses on coordinating patient care and managing cases, while the Utilization Review Nurse primarily reviews medical records to approve or deny services. Both roles require RN licensure and related certifications, but their daily responsibilities and work environments differ slightly.

Are utilization management case managers in demand?

Utilization management case managers are in demand due to the growing need for healthcare cost control and efficient patient care coordination. Employers in healthcare organizations, insurance companies, and managed care plans seek professionals with strong clinical knowledge, certification, and experience in utilization review processes. The role offers stable employment opportunities as healthcare systems focus on cost-effective treatment management.

What cities near Las Cruces, NM are hiring for Utilization Management Case Manager Rn jobs?

Cities near Las Cruces, NM with the most Utilization Management Case Manager Rn job openings:

Infographic showing various Utilization Management Case Manager Rn job openings in Las Cruces, NM as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 17% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $97,805 per year, or $47 per hour.

Director of Case Management FT

Las Cruces, NM • On-site

A24Group
201 - 500 employees
Learn more about A24Groupexternal

Full-time

Re-posted 22 hours ago

Key responsibilities

  • Provide strategic and operational leadership for the Case Management Department, including programme planning, education, monitoring, and continuous improvement

  • Oversee and supervise a multidisciplinary team of RNs, Social Workers, and Clerical Support staff

  • Direct the implementation and coordination of utilization management processes to ensure appropriate level of care and resource utilisation

Job description

Director of Case Management

Our Client  |  Las Cruces, NM 88011  |  Full-Time Exempt  |  Senior Leadership

Reports To

Chief Financial Officer

Location

Las Cruces, NM 88011 — on-site required

Salary Range

Confidential — $110,000 to $140,000

Signing Bonus

Negotiable

Visa Support

Not available

Travel

Not required

The Opportunity

Our client, a community hospital in southern New Mexico, is seeking an experienced Director of Case Management to lead the department through the full patient care continuum. This is a senior leadership role with direct accountability for clinical, financial, quality, and HR management across a multidisciplinary team of RNs, Social Workers, and Clerical Support.

The Director of Case Management will drive patient transitions through the continuum of care in a timely and cost-effective manner, ensuring both clinical outcomes and operational efficiency are optimised.

What You Will Do

Department Leadership

  • Provide strategic and operational leadership for the Case Management Department, including programme planning, education, monitoring, and continuous improvement
  • Oversee and supervise a multidisciplinary team of RNs, Social Workers, and Clerical Support staff
  • Manage departmental HR functions including hiring, onboarding, performance management, and staff development
  • Lead department meetings, maintain communication with the CFO and senior leadership, and represent Case Management in hospital-wide initiatives

Clinical & Utilization Management

  • Direct the implementation and coordination of utilization management processes to ensure appropriate level of care and resource utilisation
  • Oversee case management activities across the patient continuum including acute care, transitions, discharge planning, and post-acute follow-up
  • Ensure timely and clinically appropriate patient progression through the hospital, reducing length of stay and avoidable readmissions
  • Collaborate with physicians, nursing, ancillary services, and payers to facilitate effective care transitions
  • Monitor and manage denial prevention and appeals processes in coordination with clinical staff and payers

Financial & Quality Management

  • Monitor departmental performance against financial targets including length of stay, readmission rates, and case mix index
  • Ensure documentation standards support accurate coding, billing, and reimbursement
  • Lead quality improvement initiatives within Case Management, tracking outcomes and implementing evidence-based best practices
  • Maintain regulatory compliance with CMS, Joint Commission, and state requirements pertaining to case management and discharge planning

What We Are Looking For

Required Qualifications ★

  • ★ Current RN licence in New Mexico or valid compact licence
  • ★ Minimum three years of utilization management and case management experience
  • ★ Minimum two years of leadership experience in a healthcare setting

Preferred Qualifications

  • Certification as a Certified Case Manager (CCM) or Accredited Case Manager (ACM) — strongly preferred
  • Certification by the National Association of Healthcare Professionals or InterQual experience — desirable
  • Experience working in an acute care or for-profit hospital environment
  • Strong working knowledge of payer requirements, insurance authorisation, and denial management
  • Proficiency with EMR documentation and utilization management platforms

About Our Client

Our client is a full-service acute care community hospital in Las Cruces, southern New Mexico, serving a regional population of approximately 300,000. The facility is part of a nationally recognised health system and has been recognised for clinical excellence and workplace culture. Further details available upon candidate qualification.

Selection Process

  • Step 1: Resume review by hiring manager
  • Step 2: Video/Teams interview with CFO
  • Step 3: On-site interview with the team (if applicable)