RN Utilization Review Coordinator, Full-time

We are seeking an experienced and dynamic Registered Nurse (RN) to lead our Case Management team, with a strong focus on Utilization Review. The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post‑discharge utilization reviews to ensure appropriate patient status, medical necessity, and maintaining compliance. The role supports accurate admission status determinations, active denial management, and collaboration with physicians, case managers, and interdisciplinary team members to promote efficient patient progression through the episode of care. This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives.