Remote Clinical Review Nurse - Utilization & Discharge

Centene Corp.; Arizona; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible remote work options

Job summary

Centene Corp. is seeking a Remote Nurse Care Reviewer to perform concurrent reviews and validate the appropriate level of care for members.

The role supports inpatient and discharge planning across states including Arizona, Nevada, Oregon, and Washington, with 8am–5pm in the resident time zone and rotational weekends/holidays. Ideal candidates hold RN or LPN licensure, 2+ years of acute care experience, and familiarity with Medicare/Medicaid guidelines.

Qualifications

• Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing.
• 2–4 years of related experience; 2+ years acute care experience required.
• LPN or RN license required; RN license with Nevada compact preferred.
• Knowledge of Medicare/Medicaid regulations and utilization management preferred.

Responsibilities

• Perform concurrent reviews to determine appropriate care setting and health status.
• Review acuity, resource use, length of stay, and discharge planning.

Skills

Clinical knowledge

Assessment

Communication

Education

Bachelor’s degree in Nursing

Accredited nursing program

Tools

Health management systems

Job description

Centene Corp. is seeking a Remote Nurse Care Reviewer to perform concurrent reviews and validate the appropriate level of care for members.

The role supports inpatient and discharge planning across states including Arizona, Nevada, Oregon, and Washington, with 8am–5pm in the resident time zone and rotational weekends/holidays. Ideal candidates hold RN or LPN licensure, 2+ years of acute care experience, and familiarity with Medicare/Medicaid guidelines.