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Social Worker | RN Case Manager* 

About the Organization Thank you for your interest in exploring the professionally rewarding and personally fulfilling benefits with Tuba City Regional Health Care Corp. We look forward to continuing our discussion about the opportunity and purpose health professionals experience as valued members of TCRHCC team.

A TCRHCC career offers a chance to live and work within or near Native communities, providing clinicians/nurses/administrators with a unique opportunity to learn the heritage of the tribes we serve, discover traditions that have been carried down for generations and gain cultural insight into the beliefs and values of a deserving and appreciative patient population.


Incumbent serves as an Outpatient/Inpatient Social Worker/Registered Nurse (RN) Case Manager for TCRHCC and Sacred Peaks Healthcare Center (SPHC) and is responsible for direct supervision and supportive contact for the specific group of identified high-risk patients. The Social Worker/RN Case Manager is responsible for designing and managing a continuum of care focusing on empowering clients to achieve demonstrable outcomes and self-sufficiency. The Social Worker/RN Case Manager is responsible for assessment, service planning, and resource acquisition, monitoring progress and initiating and responding to emerging client needs. The Social Worker/RN Case Manager will link the client with Community Social Service providers, health care providers, substance abuse, and mental health providers to achieve specific goals. The Social Worker/RN Case Manager will have experience working with culturally diverse low-income populations having multiple barriers to self-sufficiency such as: illiteracy, welfare dependency, domestic violence, substance abuse, and mental health issues. The Social Worker/RN Case Manager will work with a multidisciplinary team within the service delivery setting. The Social Worker/RN Case Manager will be committed to Case Management Services and have some assignments with Purchased and Referred Care (PRC) formally known as Contract Health Services, providing assistance with the PRC Case Specialist. The Social Worker/RN Case Manager will be responsible to the Director of Case Care Coordination.


  1. Coordination of service specific assessments, service planning and enrollment
  2. Works with all facets of the Case Management continuum, i.e., social support, alternate resources, community referrals, discharge planning, Nursing Home/Skilled Nursing Placement and resource utilization.
  3. Comprehensive and client centered service planning and coordination
  4. Works proactively with the established RN Case Managers/ Social Workers of TCRHCC as a team member for care coordination of the patient populations served by TCRHCC
  5. Resource acquisition facilitated referrals and linkages
  6. Consistent and on-going case consultation with all direct service providers
  7. Developing and maintaining internal and external resource relationship
  8. Service monitoring and following up to ensure continuity of care and updating of the client service plan
  9. Identifies patient through consultation and high-risk diagnoses, i.e. COPD, CHF, DM
  10. Assists with the development of department reports, policy/procedures manuals, and program objectives
  11. Assists with special projects as assigned
  12. Conducts system and procedural efficiency evaluation to determine progress, performance, and conformity with program requirements
  13. Assist in managing outpatient referrals for PRC
  14. Follow up outside inpatient referrals for continued follow up, I.E., appointments and PHN referrals
  15. Will provide coverage for the inpatient units-ACU, PEDS, ICU, OB, and ER to include Outpatient Clinics Manages care of prioritized TCRHCC/SPHC outpatient/inpatient based upon consultation from providers within the TCRHCC/SPHC healthcare delivery system; provides a consistent and on-going consultation with service providers.
  16. Works proactively and collaboratively with Utilization Review (UR), Public Health Nursing (PHN), Patient Benefit Coordinators (PBC), and Purchased Referred Care (PRC) at TCRHCC/SPHC.
  17. Facilitates communication and coordination between members of the health care team, involving the client in the decision-making process in order to minimize fragmentation in the services (CMSA, 2010).
  18. Develops with the patient/family and multidisciplinary team (including service area and/or other non-TCRHCC/SPHC providers as appropriate) a care and service delivery plan based upon the needs identified and available provider and financial resources of the patient and provides consistent and on-going case consultation with all direct service providers.
  19. Provides service monitors and follow up to ensure continuity of care, and updates of the client service plan and provides follow up if needed. Striving to promote client self-advocacy and self-determination (CMSA, 2010).
  20. Prepares patient and family for termination (discharge) from case management when services are no longer required. Arranges for any ongoing support/direct care services that the patient will need post-discharge in coordination with discharge planners and other entities such as PHN, Community Health Representatives or Tribal Social Services.
  21. Will be familiar with Advance Directives and be a resource person for patients and families; facilitate informed choice, consent, and decision-making.
  22. Promote use of evidence-based care, as available, in conjunction with the MCG Care Guidelines.
  23. Pursue professional excellence and maintain competence in practice.
  24. Serves as the outpatient/inpatient coordinator, such as:
  • The primary contact for outpatient/inpatient in obtaining beds for admissions both within and outside of TCRHCC/SPHC.
  • Collaborates with provider and nursing personnel to ensure admissions are conducted seamlessly and without delay of patient care.
  • Collaborates with provider, nursing personnel and patient benefits coordinators that all admission documentation is complete and all referrals for third party resources are complete prior to the departure of patients.
  1. Will share in coverage all units, inpatient and outpatient for staffing shortages.
  2. Incumbent will be required to take call on scheduled weekends as deemed necessary
  3. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
  4. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updated)
  5. Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction
  6. Performs other duties as assigned.


The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.


This position requires an individual of high energy who can maintain a long and flexible schedule to meet the management requirements. The physical requirements include; sitting at a desk for long periods of time, long periods of sitting in meetings; frequent sitting for intense work on a personal computer, frequent walking to interact with staff within the facility, frequent bending, kneeling, crouching, twisting, maintaining balance and reaching.. Must be able to hear, speak and comprehend over the telephone and in person with others. Must have ability to lift, push and pull up to 50lbs frequently. Sensory requirements for position include prolonged ability for far, near, and color vision, depth perception, seeing fine details, hearing normal speech, telephone use and ability to frequently hear overhead pages. Must have ability of both hand manipulation in simple and firm grasping, fine manipulation, and use of keyboard.


Uses independent judgment and analytical skills to make decisions that impact operations, finances, and customer service within the organization. The incumbent must have the ability to perform in structured and unstructured environments and possess a keen attention to detail and propose practices/mechanisms to enhance customer satisfaction. Must have ability to continually concentrate, handle a high degree of flexibility, handle multiple priorities in stressful situation, demonstrate high degree of patience, adapt to shift work, work in areas that are close in crowded, frequently cope with high levels of stress, make decisions under high pressure, work alone, and occasionally cope with anger/fear/hostility of others in a calm way and manage altercations.


May frequently be exposed to chemical agents, extremes in temperature of humidity, occasional exposure to infectious diseases, dust, fumes, gases, hazardous or moving equipment, and loud noises.

Position Requirements



MSW Social Worker:

  • Master’s Degree in Social Work (MSW), OR

RN Case Manager:

  • Associates degree in Nursing, must obtain bachelor’s in nursing within 2 years of hire.


  • Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment

MSW Social Worker:

  • Licensed Master Social Worker (LMSW). If none, must obtain with two (2) years of hire.

RN Case Manager:

  • A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States


  • Must have a minimum of one (1) year of experience in the clinical care setting
  • Demonstrate knowledge of electronic health record systems.

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:

  • Positive working relationships with others
  • Possession of high ethical standards and no history of complaints
  • Reliable and dependable; reports to work as scheduled without excessive absences
  • Effective verbal & written communication skills
  • Team management focus promoting a positive and pro-active approach to problem resolution
  • Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
  • Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
  • Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
  • Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC.
Close Date 6/11/2022  
Exempt/Non-Exempt Non-Exempt  
Full-Time/Part-Time Full-Time  
Location Tuba City Regional Health Care Corporation  
Navajo/Indian Preference Applicants who are enrolled members of the Navajo Nation/Hopi Tribe and San Juan Southern Paiute Tribes and who meet the necessary qualifications for this position will be given preference in hiring and employment for this position.  
Open Date 4/8/2022  

This position is currently not accepting applications.

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