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Centene
Clinical Review Nurse Concurrent Review
Remote · Full time · Mid level
$27.02–$48.55 / hour
About the role
Performs concurrent reviews to evaluate member health, care necessity, and discharge planning. Assists in validating inpatient services and appropriate care settings.
What you’ll do
• Perform concurrent reviews for appropriate care and setting. • Review quality, acuity, resource use, and discharge planning. • Collaborate with Medical Affairs and Medical Directors. • Document findings and maintain records per policies. • Educate providers on utilization processes.
What you’ll bring
• Graduate from accredited nursing school or Bachelor's in Nursing. • 2-4 years related experience with 2+ years acute care. • MO RN Licensure preferred. • Knowledge of Medicare and Medicaid regulations preferred. • Knowledge of utilization management processes preferred.
Life at Centene
Offers competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off, holidays, and flexible remote work options.
About Centene
Centene connects people to needed care to improve health outcomes, supporting individuals, families, and communities with accessible healthcare.