Top 11 Utilization management nurse Jobs in Boone, Nc

Utilization Review/Patient Care Coordinator (FT)
Ashe Memorial Hospital —Jefferson, NC
- Weekends as needed
- Background check
- RN License
- Hospital
23h
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance

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Utilization Review/Patient Care Coordinator (FT)

Ashe Memorial Hospital -
Jefferson, NC

Apply Now

Job Details

Full-time
23 hours ago

Qualifications

Collaborate with healthcare professionals
RN License
BLS Certification
Managing patients as a nurse case manager
Overseeing care coordination
Utilization management
Task prioritization
Resource utilization in healthcare
Multidisciplinary team collaboration for treatment planning
Clinical confidentiality policies
Care coordination
Stakeholder relationship building

Full Job Description

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

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

Preferred Qualifications

Experience coordinating a Swing Bed or Transitional Care Program
Previous case management or discharge planning experience
Hospital-based nursing experience

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

Employment Requirements

Must meet applicable vaccination requirements
Commitment to patient confidentiality, compliance, and professional standards

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.

Apply Now

Refine Your Search

utilization management nurse jobs in boone, nc

Utilization Review/Patient Care Coordinator (FT)

Utilization Management Reviewer

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