RN Inpatient Care Coordinator

FutureSoft Consulting Inc•Sitka, AK

16h•Onsite

About The Position

We are seeking an experienced RN Inpatient Care Coordinator for a 13-week travel assignment in Sitka, Alaska. This is a senior-level care coordination and utilization management position requiring extensive clinical nursing experience combined with a strong background in medical record review, medical necessity, level-of-care determination, reimbursement, risk management, and healthcare quality. The RN Inpatient Care Coordinator will work closely with physicians, nursing teams, case management, utilization review, payers, and other healthcare professionals to promote appropriate resource utilization, support timely patient care, and ensure documentation meets clinical and reimbursement requirements.

Requirements

Active and unrestricted Alaska Registered Nurse (RN) license
Bachelor of Science in Nursing (BSN)
Minimum 8 years of clinical nursing or patient-care experience
Minimum 3 years of experience in one or more of the following: Medical record/chart review, Utilization review or utilization management, Risk management, Quality management, Case management, Related healthcare quality services
Current BLS – American Heart Association
Current ACLS – American Heart Association
Strong knowledge of medical terminology, anatomy, physiology, and disease processes
Strong written and verbal communication skills
Excellent organizational and prioritization abilities
Ability to independently evaluate complex clinical information
Experience with Medical necessity review
Experience with Level-of-care determination
Experience with Inpatient chart review
Experience with Concurrent review
Experience with Continued-stay review
Experience with Healthcare reimbursement requirements
Experience with Public and private insurance processes
Experience with CMS regulations
Experience with Clinical documentation review
Experience with Risk and quality assessment
Experience with Resource utilization
Working knowledge of ICD coding principles
Working knowledge of CPT coding principles
Working knowledge of Centers for Medicare & Medicaid Services (CMS) requirements
Working knowledge of Hospital reimbursement processes
Working knowledge of Medical necessity criteria
Working knowledge of Clinical documentation standards
Working knowledge of Healthcare regulatory requirements
Flu vaccination is required unless an approved exemption is permitted under facility policy.
All required certifications and licenses must remain current throughout the contract.

Nice To Haves

Case Management certification from a recognized certifying organization
CCM – Certified Case Manager
Other recognized utilization management or case management certification
Previous inpatient hospital case management experience
Utilization Review RN experience
Clinical Documentation Improvement experience
Risk management experience
Quality improvement experience
Medicare and Medicaid reimbursement knowledge
Previous travel nursing experience

Responsibilities

Review inpatient medical records for medical necessity and appropriate level of care.
Evaluate patient status and documentation to support appropriate admission and continued-stay decisions.
Conduct concurrent and retrospective medical record reviews as required.
Assess clinical documentation for completeness and alignment with reimbursement requirements.
Support utilization management and appropriate use of hospital resources.
Collaborate with physicians and clinical staff to clarify documentation and care requirements.
Identify potential barriers to appropriate patient progression and coordinate resolution.
Review patient cases for compliance with payer and regulatory guidelines.
Support appropriate reimbursement from Medicare, Medicaid, and commercial insurance plans.
Apply knowledge of CMS requirements to inpatient care and utilization review activities.
Assist with denial prevention and identify documentation issues that may affect reimbursement.
Communicate with payers and utilization review representatives when required.
Participate in interdisciplinary rounds and patient-care discussions.
Support safe and appropriate transitions between levels of care.
Identify quality, risk, or patient-safety concerns through medical record review.
Escalate cases requiring physician, leadership, or multidisciplinary review.
Maintain accurate and timely documentation of utilization and care-coordination activities.
Protect confidential patient information and comply with all privacy requirements.
Collaborate effectively with providers, nursing staff, patients, case managers, and hospital leadership.