RN - Patient Care Coordinator
$3,138 per monthWellStar Kennestone Hospital
Details Client Name
Mt. Edgecumbe Medical Center
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Patient Care Coordinator
Job ID
18972921
Job Title
RN - Patient Care Coordinator
Weekly Pay
$3138.0
Shift Details Shift
8 Hour Days
Scheduled Hours
40
Job Order Details Start Date
10/05/2026
End Date
01/04/2027
Duration
13 Week(s)
Job Description
Utilization Review Nurse Job Description This position involves managing patient progression of care, promoting evidence-based protocols, ensuring appropriateness of interventions, and expediting care delivery for patients admitted. The role focuses on the coordination of patient care services to ensure timely and appropriate patient discharge. Key Essential Functions and Accountabilities
222 Tongass Ave
City
Sitka
State
AK
Zip Code
99835
Mt. Edgecumbe Medical Center
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Patient Care Coordinator
Job ID
18972921
Job Title
RN - Patient Care Coordinator
Weekly Pay
$3138.0
Shift Details Shift
8 Hour Days
Scheduled Hours
40
Job Order Details Start Date
10/05/2026
End Date
01/04/2027
Duration
13 Week(s)
Job Description
Utilization Review Nurse Job Description This position involves managing patient progression of care, promoting evidence-based protocols, ensuring appropriateness of interventions, and expediting care delivery for patients admitted. The role focuses on the coordination of patient care services to ensure timely and appropriate patient discharge. Key Essential Functions and Accountabilities
- Review patients' records and evaluate patient progress.
- Perform continuing review of patient hospitalization to monitor necessity for and appropriateness of care, length of stay, and quality of care.
- Provide Utilization Management (UM) functions for beneficiary patients admitted to other facilities.
- Obtain and review necessary medical reports and treatment plans as requested by regulatory agencies or payers.
- Review and validate physician orders, reporting progress and unusual occurrences on patients.
- Collaborate with leadership, clinical care teams, and physicians to ensure healthcare services are appropriate and cost-effective.
- Review new hospital admissions to assess patient conditions and needs to develop personalized treatment plans.
- Provide necessary information to patients and/or their families regarding their healthcare benefits.
- Ensure documentation supports UM functions and communicate with payers within required timeframes.
- Manage appeals for denials and respond to complaints per UM review guidelines.
- Maintain utilization review and appeal logs.
- Support continuous quality improvement activities through quality review initiatives.
- Active nursing license in Alaska is required.
- Bachelor's Degree in Nursing is required.
- At least 8 years of clinical care or nursing experience, with 3 years in chart review, risk management, or related quality services.
- Case Management certification by a recognized certifying organization (i.e., NCQA, CCMC) is preferred.
- Strong knowledge of conducting and reviewing medical records for medical necessity and level of care.
- Familiarity with regulations set forth by The Centers for Medicare & Medicaid Services.
- Ability to assess patient situations and take effective courses of action.
- Strong written and oral communication skills.
- Strong organizational skills and the ability to collaborate effectively with providers, staff, and patients.
222 Tongass Ave
City
Sitka
State
AK
Zip Code
99835
Vacancy posted 2 days ago
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