Utilization Review/Patient Care Coordinator (FT)

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    "description": "<p><span style=\"font-size: 24pt\"><span><span style=\"font-weight: bold\">Registered Nurse (RN) – Utilization Review / Patient Care Coordinator</span></span></span></p>\n<p><span style=\"font-weight: bold\">Care Coordination | Ashe Memorial Hospital | West Jefferson, NC</span></p>\n<p>At Ashe Memorial Hospital, our mission guides every aspect of care:<br><span style=\"font-weight: bold\">“To meet the needs of the community by delivering patient-centered, high-quality health care.”</span></p>\n<p>We are proud to be recognized as <em>Ashe’s Best Place to Work</em> 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.</p>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Position Overview</span></span></span></p>\n<p>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.</p>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Position Details</span></span></span></p>\n<ul>\n<li><span style=\"font-weight: bold\">Employment Type:</span> Full-Time (40 hours/week)</li>\n<li><span style=\"font-weight: bold\">Shift:</span> Day Shift (Monday–Friday)</li>\n<li><span style=\"font-weight: bold\">Schedule:</span> Occasional evenings/weekends as needed</li>\n<li><span style=\"font-weight: bold\">Department:</span> Care Coordination / Utilization Review</li>\n<li><span style=\"font-weight: bold\">Travel:</span> None required</li>\n<li><span style=\"font-weight: bold\">Compensation:</span> Commensurate with experience</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Why Join Ashe Memorial Hospital</span></span></span></p>\n<ul>\n<li>Leadership-focused nursing role with system-wide impact</li>\n<li>Collaborative, interdisciplinary team environment</li>\n<li>Opportunity to influence patient outcomes and care transitions</li>\n<li>Recognition as a multi-year <em>Best Place to Work</em></li>\n<li>Professional growth and development opportunities</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Key Responsibilities</span></span></span></p>\n<ul>\n<li>Coordinate and manage the Swing Bed (Transitional Care) Program</li>\n<li>Review admissions for medical necessity and regulatory compliance</li>\n<li>Conduct utilization reviews to optimize length of stay and resource use</li>\n<li>Manage internal and external referrals and build provider relationships</li>\n<li>Collaborate with physicians, case management, and interdisciplinary teams</li>\n<li>Support discharge planning for safe and timely transitions of care</li>\n<li>Handle pre-authorizations and follow up on denials</li>\n<li>Ensure compliance with regulatory, accreditation, and hospital standards</li>\n<li>Maintain accurate documentation and reporting</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Minimum Qualifications</span></span></span></p>\n<ul>\n<li><span style=\"font-weight: bold\">Licensure:</span> Current Registered Nurse (RN) license in North Carolina</li>\n<li><span style=\"font-weight: bold\">Certification:</span> Basic Life Support (BLS) – required</li>\n<li><span style=\"font-weight: bold\">Experience:</span> Utilization Review experience – required</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Preferred Qualifications</span></span></span></p>\n<ul>\n<li>Experience with Swing Bed or Transitional Care programs</li>\n<li>Case management or discharge planning experience</li>\n<li>Hospital-based clinical experience</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Core Competencies</span></span></span></p>\n<ul>\n<li>Strong organizational and time management skills</li>\n<li>Excellent communication and relationship-building abilities</li>\n<li>Critical thinking and problem-solving expertise</li>\n<li>Knowledge of regulatory and compliance standards</li>\n<li>Commitment to patient-centered care and quality outcomes</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Employment Requirements</span></span></span></p>\n<ul>\n<li>Compliance with all hospital policies, including vaccination requirements (approved exemptions considered)</li>\n<li>Successful completion of a criminal background check and pre-employment drug screening (post-offer)</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Benefits</span></span></span></p>\n<p>Comprehensive benefits begin <span style=\"font-weight: bold\">the first of the month following employment</span>, in accordance with hospital policy.</p>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">How to Apply</span></span></span></p>\n<p>Interested candidates should submit:</p>\n<ul>\n<li>Completed application</li>\n<li>Resume</li>\n<li>Cover letter</li>\n</ul>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Equal Opportunity Employer</span></span></span></p>\n<p>Ashe Memorial Hospital is an Equal Opportunity Employer. Employment decisions are based on qualifications, merit, and organizational needs.</p>\n<p><span style=\"font-size: 18pt\"><span><span style=\"font-weight: bold\">Make a Meaningful Impact</span></span></span></p>\n<p>In this role, your work extends beyond the bedside—helping ensure patients receive the right care, at the right time, in the right setting.</p>",
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