Top 7 Utilization review nurse Jobs in Charleston, Sc

Nurse - MDS Coordinator
Ashley River Healthcare —Charleston, SC
- $75,000 - $88,000 a year
- Full-time
- Nursing
- Anatomy knowledge
- RN License
- Health insurance
- Dental insurance
Quick Apply
3d
Registered Nurse RN 13 week contract
Interim HealthCare - North Charleston, SC —North Charleston, SC
- $45 an hour
- Contract
- CPR Certification
- Nursing
- RN License
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RN Care Manager - Exempt
BoldAge PACE —North Charleston, SC
- Nursing
- RN License
- Bachelor of Science
- Health insurance
- Dental insurance
Quick Apply

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Nurse - MDS Coordinator

Ashley River Healthcare
Charleston, SC

Quick Apply

Job Details

Full-time
$75,000 - $88,000 a year
3 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Life insurance

Qualifications

Anatomy knowledge
HIPAA
Health information management
Medical terminology
Hospital experience

Full Job Description

Job Summary
We are seeking a dedicated and detail-oriented MDS Nurse to join our healthcare team. In this vital role, you will lead the comprehensive assessment and documentation of residents’ clinical needs, ensuring compliance with regulatory standards and optimizing patient care. Your expertise will support interdisciplinary teams in developing personalized care plans, managing medical documentation, and facilitating smooth discharge planning. This position offers an exciting opportunity to make a meaningful impact in a dynamic healthcare environment, utilizing your advanced nursing skills and clinical knowledge to enhance patient outcomes.

Duties

Conduct thorough Minimum Data Set (MDS) assessments for residents, capturing detailed clinical information to inform care planning and reimbursement processes.
Review and analyze medical records, clinical documentation, and coding details such as ICD-10, CPT, and DRG to ensure accuracy and completeness.
Collaborate with interdisciplinary teams—including physicians, therapists, social workers, and nurses—to develop individualized care plans aligned with regulatory standards and CMS guidelines.
Perform utilization review and management activities to optimize resource use while maintaining high-quality patient care.
Maintain compliance with HIPAA regulations by safeguarding patient information within electronic health record (EHR) systems. We primarily use Point Click Care (PCC).
Facilitate discharge planning by coordinating with families, outpatient providers, hospice services, and home care agencies to ensure seamless transitions of care.
Participate in clinical documentation improvement initiatives to enhance accuracy in medical records and support appropriate reimbursement through proper coding practices.

Skills

Extensive knowledge of medical terminology, anatomy, physiology, and nursing practices across inpatient, outpatient, hospice, and long-term care settings.
Proficiency with EMR/EHR systems, especially Point Click Care (PCC).
Strong understanding of managed care principles, Medicare/Medicaid regulations, NCQA standards, and DRG-based reimbursement models.
Experience with ICD-9/ICD-10 coding systems; CPT coding; utilization review; case management; and health information management.
Understanding of Short-term Rehab and Long-term care standards of care and Medicaid Levels of Care.
Ability to interpret complex medical records and perform detailed documentation review while ensuring compliance with HIPAA standards.
Excellent communication skills for collaborating effectively with multidisciplinary teams and educating staff on documentation best practices.
Knowledge of hospital operations including discharge planning processes, emergency medicine procedures, PICU protocols, and outpatient clinic workflows. Join us as an MDS Nurse where your expertise will directly influence quality patient outcomes while advancing your career in a vibrant healthcare environment committed to excellence!
Must have active RN or LPN license good for use in the state of South Carolina.

For more details regarding benefits: check us out here http://www.ensignbenefits.com/

Benefits eligibility for some benefits dependent on full time employment status

Pay: $75,000.00 - $88,000.00 per year

Benefits:

401(k)
Dental insurance
Employee assistance program
Health insurance
Life insurance
Paid time off
Vision insurance

License/Certification:

RN or LPN license (Required)

Work Location: In person

Quick Apply

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utilization review nurse jobs in charleston, sc

Nurse - MDS Coordinator

Registered Nurse RN 13 week contract

RN Care Manager - Exempt

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