RN Utilization Manager: Care Coordination Lead

UNC REX Healthcare; North Carolina; On-site; USD 102,783,000 - 147,768,000; Full time

Job summary

UNC Health in Smithfield, NC is seeking a Utilization Manager to collaborate with patients, families, physicians, and care teams to coordinate care across the hospital and post-discharge.

You will conduct admission, continued stay, and discharge reviews, ensure timely documentation, and support revenue protection through accurate medical necessity reviews.

This onsite role requires NC RN licensure, at least two years of clinical experience, and ability to communicate across disciplines.

Qualifications

• Graduation from a state-accredited school of professional nursing.
• Licensed to practice as a Registered Nurse in North Carolina.
• Two years of clinical experience in a medical facility or UM setting.

Responsibilities

• Perform admission, continued stay, and discharge reviews within 24 hours to ensure appropriateness.
• Collaborate with physicians, nursing staff and payors to coordinate care.
• Identify high-risk cases and facilitate timely documentation and transitions.
• Provide revenue protection through accurate coding and medical necessity determinations.

Skills

Registered Nurse (RN)

Clinical coordination

Interdisciplinary collaboration

Education

Bachelor's degree in Nursing

Nursing licensure in NC

Job description

UNC Health in Smithfield, NC is seeking a Utilization Manager to collaborate with patients, families, physicians, and care teams to coordinate care across the hospital and post-discharge.

You will conduct admission, continued stay, and discharge reviews, ensure timely documentation, and support revenue protection through accurate medical necessity reviews.

This onsite role requires NC RN licensure, at least two years of clinical experience, and ability to communicate across disciplines.