Inpatient Care Coordinator
Sitka, Alaska
Mount Edgecumbe Hospital

Registered Nurse - Inpatient Care Coordinator

Location: Sitka, Alaska
Employment Type: Contract
Contract Length: 13 weeks
Hours per Week: 40
Shift: To be discussed at interview

Job Summary

• Manage patient progression of care, promote evidence-based protocols, and ensure timely, appropriate patient discharge.
• Review patient records and evaluate patient progress, including necessity and appropriateness of hospitalization, length of stay, and quality of care.
• Collaborate with physicians, clinical care teams, and leadership to ensure healthcare services are appropriate, cost-effective, and adhere to utilization management (UM), case management (CM), and discharge care planning (DCP) protocols.
• Facilitate educational programs and advise on regulations affecting UM/CM/DCP.
• Coordinate patient care departments to ensure treatment plans meet hospital and regulatory/payer criteria.
• Maintain documentation supporting UM functions and communicate with payers within required timeframes.
• Process appeals of denials and respond to complaints per UM review guidelines.
• Support clinical improvement activities by providing quality review and perform tumor registry functions.

Required Qualifications

• Active Alaska Registered Nurse (RN) license at time of submission.
• Bachelor’s Degree in Nursing.
• Minimum 8 years of clinical nursing experience, including at least 3 years in chart review, risk management, or related quality service.
• Case Management certification (e.g., NCQA, CCMC) preferred but not required.
• Basic Life Support (BLS/BCLS) certification.
• Flu vaccine 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 from The Centers for Medicare & Medicaid Services (CMS).
• 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

• Start date will be no less than 6 weeks after fingerprint cards are received for processing; timely submission of fingerprints is required to avoid delays.
• Applicants must live at least 50 miles away from the work location.
• Housing and flights are not provided.

Supervisory Responsibilities

• This position does not require supervisory responsibilities.