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.

• 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