Utilization Review/Patient Care Coordinator (FT)

Job Description

Job Description

Registered Nurse (RN) – Utilization Review / Patient Care Coordinator

Care Coordination | Ashe Memorial Hospital | West Jefferson, NC

At Ashe Memorial Hospital, our mission guides every aspect of care: “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 from 2022 through 2025 and for excellence across our providers, nurses, and patient care teams. Join an organization where your expertise shapes patient outcomes from admission through discharge.

Position Overview

The RN – Utilization Review / Patient Care Coordinator plays a critical role in care coordination, overseeing both Utilization Review and the Swing Bed (Transitional Care) Program. This position ensures appropriate resource utilization, regulatory compliance, and safe, efficient transitions of care for patients.

Position Details

• Employment Type: Full-Time (40 hours/week)
• Shift: Day Shift (Monday–Friday)
• Schedule: Occasional evenings/weekends as needed
• Department: Care Coordination / Utilization Review
• Travel: None required
• Compensation: Commensurate with experience

Why Join Ashe Memorial Hospital

• Leadership-focused nursing role with system-wide impact
• Collaborative, interdisciplinary team environment
• Opportunity to influence patient outcomes and care transitions
• Recognition as a multi-year Best Place to Work
• Professional growth and development opportunities

Key Responsibilities

• Coordinate and manage the Swing Bed (Transitional Care) Program
• Review admissions for medical necessity and regulatory compliance
• Conduct utilization reviews to optimize length of stay and resource use
• Manage internal and external referrals and build provider relationships
• Collaborate with physicians, case management, and interdisciplinary teams
• Support discharge planning for safe and timely transitions of care
• Handle pre-authorizations and follow up on denials
• Ensure compliance with regulatory, accreditation, and hospital standards
• Maintain accurate documentation and reporting

Minimum Qualifications

• Licensure: Current Registered Nurse (RN) license in North Carolina
• Certification: Basic Life Support (BLS) – required
• Experience: Utilization Review experience – required

Preferred Qualifications

• Experience with Swing Bed or Transitional Care programs
• Case management or discharge planning experience
• Hospital-based clinical experience

Core Competencies

• Strong organizational and time management skills
• Excellent communication and relationship-building abilities
• Critical thinking and problem-solving expertise
• Knowledge of regulatory and compliance standards
• Commitment to patient-centered care and quality outcomes

Employment Requirements

• Compliance with all hospital policies, including vaccination requirements (approved exemptions considered)
• Successful completion of a criminal background check and pre-employment drug screening (post-offer)

Benefits

Comprehensive benefits begin the first of the month following employment , in accordance with hospital policy.

How to Apply

Interested candidates should submit:

• Completed application
• Resume
• Cover letter

Equal Opportunity Employer

Ashe Memorial Hospital is an Equal Opportunity Employer. Employment decisions are based on qualifications, merit, and organizational needs.

Make a Meaningful Impact

In this role, your work extends beyond the bedside—helping ensure patients receive the right care, at the right time, in the right setting.