Registered Nurse – Utilization Review / Patient Care Coordinator
Full-Time
No salary listed
Mid
Jefferson, NC, USA
In Person
Medical, Clinical & Veterinary
About the job
Requirements
A current, unrestricted North Carolina Registered Nurse license is required.
BLS Certification is required.
Previous Utilization Review experience is required.
Strong communication, organization, and care coordination skills are required.
The ability to manage multiple priorities while maintaining accuracy and attention to detail is required.
Demonstrated ability to collaborate effectively with physicians, clinical teams, patients, and external partners is required.
Applicable vaccination requirements must be met.
The role requires commitment to patient confidentiality, compliance, and professional standards.
A background check and drug screening are required upon offer.
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.
Desired 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.
Knowledge of utilization management and regulatory requirements.
Registered Nurse – Utilization Review / Patient Care Coordinator
Ashe Memorial Hospital | West Jefferson, NC Full-Time | Monday–Friday | 1st Shift
Coordinate Care. Improve Outcomes. Make a Difference.
At Ashe Memorial Hospital, we are committed to our mission: “To meet the needs of the community by delivering patient-centered, high-quality health care.”
We are proud to be recognized as Ashe’s Best Place to Work for 2022, 2023, 2024, and 2025, reflecting our commitment to creating a supportive, collaborative environment where our team members can thrive.
We are seeking an experienced Registered Nurse – Utilization Review / Patient Care Coordinator to join our team. This position plays a vital role in coordinating patient care, supporting appropriate utilization of services, and facilitating safe and effective transitions across the continuum of care.
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.