Utilization Review/Patient Care Coordinator (FT)

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.

Make a BIG difference in a SMALL community.