RN: Utilization Review & Transitional Care Coordinator

Ashe Memorial Hospital; Jefferson (NC); On-site; USD 70,000 - 95,000; Full time

Job summary

Ashe Memorial Hospital in West Jefferson, NC seeks a Registered Nurse – Utilization Review / Patient Care Coordinator to coordinate care, support appropriate utilization of services, and facilitate safe transitions across the continuum of care.

This full-time, first-shift role partners with physicians and care teams to manage Swing Bed and Transitional Care programs, conduct reviews for medical necessity, and ensure regulatory compliance while guiding discharge planning.

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.

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.

Skills

Communication

Organization

Care coordination

Education

Registered Nurse License (NC)

BLS Certification

Job description

Ashe Memorial Hospital in West Jefferson, NC seeks a Registered Nurse – Utilization Review / Patient Care Coordinator to coordinate care, support appropriate utilization of services, and facilitate safe transitions across the continuum of care.

This full-time, first-shift role partners with physicians and care teams to manage Swing Bed and Transitional Care programs, conduct reviews for medical necessity, and ensure regulatory compliance while guiding discharge planning.