Job Title: RN Inpatient Care Coordinator / Utilization Management
Job Type: Contract
Contract Duration: 13 Weeks
Start Date: October 5, 2026
Schedule: Day Shift
Specialty: Nursing – Care Management
The pay rate for a local candidate is $10 less than the rate offered to a travel candidate
Position Overview
We are seeking an experienced Registered Nurse (RN) Inpatient Care Coordinator to manage patient progression of care, utilization review, care coordination, and discharge planning.
The ideal candidate will have extensive clinical nursing experience with strong expertise in chart review, utilization management, risk management, quality services, and inpatient care coordination. This role works closely with physicians, clinical leadership, patients, families, payers, and multidisciplinary teams to ensure appropriate, timely, and cost-effective care.
Key Responsibilities
- Manage and monitor the progression of care for hospitalized patients.
- Review patient medical records and evaluate clinical progress.
- Conduct ongoing utilization review to assess medical necessity, level of care, length of stay, and quality of care.
- Review new hospital admissions and assess patient conditions and care needs.
- Develop and support individualized treatment and discharge plans.
- Review and validate physician orders, treatment plans, reports, and clinical documentation.
- Collaborate with physicians, hospital leadership, and multidisciplinary clinical teams.
- Ensure patient care meets hospital, regulatory, and payer requirements.
- Communicate with insurance companies and payers within required timeframes.
- Review medical records and obtain required reports for regulatory agencies and payers.
- Provide patients and families with information regarding healthcare benefits when appropriate.
- Maintain accurate Utilization Management, Care Management, Discharge Planning, and appeal documentation.
- Process requests for appeals and respond to complaints according to established guidelines.
- Maintain utilization review and appeal logs.
- Support quality improvement initiatives through clinical and utilization reviews.
- Assist with Purchased/Referred Care Services patients receiving care at outside facilities.
- Provide education and guidance to physicians and departments regarding utilization management regulations.
- Prepare notification letters and required information for providers, staff, and patients.
- Perform tumor registry functions as assigned.
- Perform other duties as assigned.
Required Qualifications
- Bachelor’s Degree in Nursing (BSN) required.
- Active Alaska RN license is mandatory at the time of submission.
- Agency/travel candidates must have an active Alaska nursing license.
- Minimum 8 years of clinical care or nursing experience.
- At least 3 years of experience in chart review, risk management, utilization management, or related quality services.
- Strong knowledge of medical terminology, anatomy, physiology, and disease processes.
- Knowledge of medical necessity and level-of-care review.
- Knowledge of public and private insurance reimbursement requirements.
- Understanding of CMS (Centers for Medicare & Medicaid Services) regulations.
- Basic knowledge of ICD-9 and CPT coding.
- Strong written and verbal communication skills.
- Excellent organizational and analytical skills.
Preferred Qualifications
- Case Management certification from a recognized organization such as CCM/CCMC or NCQA preferred.
- Previous experience in Utilization Review (UR), Utilization Management (UM), Case Management, Discharge Planning, or Care Coordination preferred.
- Experience working with hospital-based multidisciplinary teams preferred.
Compliance Requirements
- Active Alaska RN license required at submission.
- Flu vaccination required.
- Fingerprint cards are required for background clearance.
- After acceptance, the traveler must schedule fingerprinting and mail the fingerprint cards to SEARHC in Juneau within 2–3 days.
- The start date will be no less than 6 weeks after SEARHC receives the fingerprint cards for processing.
- Delays in submitting fingerprints may result in the start date being pushed back.
Pay: $84.00 - $88.00 per hour
Education:
Experience:
- clinical care or nursing experience.: 8 years (Required)
- chart review, risk management, utilization management: 3 years (Required)
- hospital-based multidisciplinary teams : 2 years (Preferred)
License/Certification:
- Active Alaska RN license (Required)
- Case Management certification (Preferred)
Work Location: In person
