RN Inpatient Care Coordinator
Sitka, AK
Catalytic Solutions
5x8 hrs, Flexible
Referral Bonus

Registered Nurse - Inpatient Care Coordinator

Location: Sitka, Alaska
Employment Type: Contract
Contract Length: 13 weeks

Job Summary

Manage patient progression of care by promoting evidence-based protocols, ensuring appropriate interventions, and expediting care delivery for admitted patients. Direct patient care services to ensure timely and appropriate patient discharge. Collaborate with clinical teams and physicians to ensure healthcare services are appropriate and cost-effective.

Key Responsibilities

• Review patient records and evaluate patient progress.
• Perform ongoing review of hospitalizations to monitor necessity, length of stay, and quality of care.
• Provide utilization management (UM) and review functions for patients admitted to other facilities.
• Obtain and review medical reports and treatment plans as requested by regulatory agencies or payers.
• Validate physician orders and report patient progress and unusual occurrences.
• Collaborate with leadership, clinical care teams, and physicians to ensure adherence to UM/Case Management/Discharge Care Plans.
• Assess new hospital admissions to develop personalized treatment plans.
• Provide patients and families with information regarding healthcare benefits.
• Participate in interdisciplinary collaboration with professional staff.
• Maintain Utilization Review Plan and support educational programs related to UM/CM/DCP.
• Coordinate patient care departments to ensure treatment plans meet hospital and regulatory criteria.
• Ensure documentation supports UM functions and communicate with payers within required timeframes.
• Prepare information for notifications and process appeals of denials.
• Respond to complaints per UM review guidelines.
• Maintain utilization review and appeal logs.
• Support clinical improvement activities by providing quality review.
• Perform tumor registry functions.
• Other duties as assigned.

Required Qualifications

• Active Alaska Registered Nurse (RN) license at time of submission.
• Bachelor’s Degree in Nursing.
• Minimum 8 years of clinical care or nursing experience, including at least 3 years in chart review, risk management, or related quality service.
• Case Management certification (e.g., NCQA, CCMC) preferred.
• Basic Life Support (BLS/BCLS) certification.
• High school diploma or equivalent required.

Knowledge & Skills

• Proficient in medical terminology, anatomy, physiology, and disease concepts.
• Knowledge of medical record review for medical necessity, level of care, and insurance reimbursement.
• Familiarity with ICD-9 and CPT coding.
• Understanding of regulations set by Centers for Medicare & Medicaid Services.
• Strong written and oral communication skills.
• Strong organizational skills.
• Ability to assess patient situations and take effective nursing actions.
• Ability to communicate and collaborate effectively with providers, staff, and patients.

Additional Information

• Flu vaccine required.
• Start date will be no less than 5 weeks after fingerprint processing.
• Applicants must live at least 50 miles from the work location.
• Housing and travel expenses are not provided.

Supervisory Responsibilities

• This position does not require supervisory responsibilities.

Prior Travel Experience

• Not explicitly required.