RN Utilization Coordinator: Case Management Lead

North Mississippi Health Services; Tupelo (MS); On-site; USD 62,000 - 86,000; Full time

Job summary

North Mississippi Health Services seeks an experienced Registered Nurse for case management and coordination across inpatient and outpatient settings. The role emphasizes collaborating with physicians, payers, and the care team to determine appropriate levels of care and ensure compliant documentation.

The ideal candidate will have an active Mississippi RN license, a minimum of five years of healthcare experience, and strong organizational and communication skills.

Qualifications

• Requires Associates Degree in Nursing; Bachelor's preferred.
• Licensed as a Registered Nurse by the Mississippi Board of Nursing.
• Minimum of 5 years clinical/healthcare experience required.
• Excellent organizational and written/verbal communication skills required.
• Certified Accredited Case Manager (ACM) desirable.

Responsibilities

• Coordinates with physician services and care teams to determine patient status.
• Reviews clinical data and payer guidelines to support appropriate level of care.
• Notifies and coordinates with inpatient/outpatient services and payers.
• Maintains documentation and shares medical necessity information with payers.
• Adheres to NMHS/NMMC policies and applicable laws and regulations.

Skills

Organizational skills

Written & verbal communication

Interpersonal skills

Care coordination

Education

Associates Degree in Nursing

Bachelor’s Degree preferred

Registered Nurse (RN) license—Mississippi

ACM certification desirable

Job description

North Mississippi Health Services seeks an experienced Registered Nurse for case management and coordination across inpatient and outpatient settings. The role emphasizes collaborating with physicians, payers, and the care team to determine appropriate levels of care and ensure compliant documentation.

The ideal candidate will have an active Mississippi RN license, a minimum of five years of healthcare experience, and strong organizational and communication skills.