Utilization Review/Patient Care Coordinator (FT)

About the Position

This is a key nursing coordination role with responsibility for Utilization Review and the Transitional Care (Swing Bed) Program. The ideal candidate will be organized, detail-oriented, and confident working collaboratively with physicians, clinical teams, patients, families, and external partners.

Key Responsibilities

• Coordinate and manage the Swing Bed/Transitional Care Program
• Conduct utilization reviews to ensure appropriate levels of care and optimize length of stay
• Review admissions for medical necessity and regulatory compliance
• Coordinate internal and external referrals and establish strong provider relationships
• Collaborate with physicians, case management, nursing, and interdisciplinary care teams
• Support comprehensive discharge planning and safe, timely transitions of care
• Complete pre-authorizations and follow up on denials and related payer requirements
• Monitor and maintain compliance with applicable regulatory, accreditation, and organizational standards
• Serve as a resource to clinical teams regarding utilization, care coordination, and regulatory requirements

Schedule

• Full-Time | 40 hours per week
• Monday–Friday | 1st Shift
• Occasional evenings or weekends as needed
• No travel required

Minimum Qualifications

• Current, unrestricted North Carolina Registered Nurse (RN) license
• BLS Certification
• Previous Utilization Review experience required
• Strong communication, organization, and care coordination skills
• Ability to manage multiple priorities while maintaining accuracy and attention to detail
• Demonstrated ability to collaborate effectively with physicians, clinical teams, patients, and external partners

Preferred Qualifications

• Experience coordinating a Swing Bed or Transitional Care Program
• Previous case management or discharge planning experience
• Hospital-based nursing experience
• Knowledge of healthcare regulatory, accreditation, and payer requirements

What We’re Looking For

The ideal candidate will bring:

• Excellent organizational and problem-solving skills
• Strong interpersonal and communication abilities
• The ability to build effective relationships across departments and organizations
• Knowledge of utilization management and regulatory requirements
• A commitment to patient-centered, high-quality care
• A collaborative, professional, and team-oriented approach

Employment Requirements

• Must meet applicable vaccination requirements
• Commitment to patient confidentiality, compliance, and professional standards
• Background check and drug screening required upon offer

Ready to Make a Difference?

If you are an experienced RN who is passionate about care coordination, quality, and helping patients successfully navigate their healthcare journey, we invite you to join the team at Ashe Memorial Hospital.

Apply today and bring your expertise to a team where your work makes a meaningful difference.

Make a BIG difference in a SMALL community.