Care Coordination & Utilization Review Specialist

MACON HOSPITAL INC; Lafayette (TN); On-site; USD 67,000 - 89,000; Full time

Job summary

Macon Hospital Inc. in Lafayette, TN is seeking a Full Time Case Manager to coordinate care across interdisciplinary teams, conduct comprehensive patient assessments, and facilitate discharge planning.

The role requires an RN license in Tennessee, 2–3 years of healthcare experience, and proficiency in utilization review processes. You will engage in quality improvement activities, support social services and ensure timely, appropriate resource utilization to optimize patient outcomes.

Qualifications

• Licensure/certification in Case Management preferred.
• Education: High School diploma; training in medical terminology, anatomy & physiology.
• 2–3 years experience in health care facilities; Case Management/Utilization Review preferred.
• Strong communication and teamwork skills; ability to work independently within guidelines.

Responsibilities

• Coordinate care with interdisciplinary teams to support patient outcomes.
• Perform comprehensive assessments of patient care needs and discharge planning.
• Lead or participate in discharge planning meetings to review progress and barriers.
• Assist with social services and discharge planning needs.
• Perform admission and concurrent utilization reviews to evaluate appropriateness of care.
• Monitor utilization trends and participate in quality improvement activities.

Skills

Strong communication

Team collaboration

Professional demeanor

Education

High School diploma

Interqual criteria training

BSN preferred

Job description

Macon Hospital Inc. in Lafayette, TN is seeking a Full Time Case Manager to coordinate care across interdisciplinary teams, conduct comprehensive patient assessments, and facilitate discharge planning.

The role requires an RN license in Tennessee, 2–3 years of healthcare experience, and proficiency in utilization review processes. You will engage in quality improvement activities, support social services and ensure timely, appropriate resource utilization to optimize patient outcomes.