Case Management / Utilization Review / Documentation Specialist

Job overview

The Case Management / Utilization Review / Documentation Specialist role is onsite in Lafayette, TN; the stated pay range is $32–$43 per hour. The position is in Macon Community Hospital’s Care Management department. The role coordinates patient care and discharge planning, reviews medical necessity and resource utilization, and improves clinical documentation. It supports safe transitions, appropriate levels of care, payer requirements, and accurate records in collaboration with the interdisciplinary care team.

What you'll do

• Assess patient care needs, psychosocial barriers, discharge needs, and support systems
• coordinate discharge planning and referrals
• facilitate interdisciplinary rounds
• conduct admission and concurrent utilization reviews
• monitor length of stay and utilization indicators
• support denials and appeals
• coordinate swing bed referrals and authorizations
• review clinical documentation and communicate with providers about documentation quality
• support coding accuracy and clinical validation
• coordinate the peer review function. Requires a current Tennessee registered nursing license
• case management, utilization review, and documentation credentials are preferred, with specified registration and certification timelines if not already held.

What we're looking for

Skills & competencies

case management

utilization review

documentation specialist

registered nurse

lafayette tn

macon community hospital

care management

discharge planning

medical necessity

clinical documentation

swing bed

$32-$43 per hour

Work arrangement

• Weekend coverage required

Why this role

Combines case management, utilization review, swing bed coordination, clinical documentation review, and peer review responsibilities; current Tennessee registered nursing license required.

About the employer

MACON HOSPITAL INC is hiring for this role. Industry: All Other Miscellaneous Ambulatory Health Care Services. Sector: 62.