Remote Concurrent Review Nurse - Utilization Management

Centene Corporation; Michigan; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a remote Utilization Management reviewer with an RN or LPN license and 2–4 years of clinical experience. The role involves concurrent reviews, care setting determinations, and collaboration with medical leadership to ensure appropriate care levels across patient populations.

Requirements include nursing licensure (RN/LPN) and a willingness to obtain licensure in additional states as needed. Monday–Friday day schedule with competitive pay and benefits.

Qualifications

• Graduate from an accredited School of Nursing or a Bachelor's degree in Nursing.
• 2–4 years of related experience; 2+ years acute care experience required.
• LPN or RN licensure; compact state licensure preferred.

Responsibilities

• Performs concurrent reviews to determine appropriate level of care.
• Reviews acuity, resource use, length of stay, and discharge planning.
• Collaborates with Medical Affairs/Medical Directors on patient care.

Skills

Clinical knowledge

Utilization management

Regulatory knowledge

Education to providers

Education

Nursing degree (RN or BSN)

2–4 years related experience

Acute care experience

Tools

EMR systems

Utilization review tools

Job description

Centene Corporation is seeking a remote Utilization Management reviewer with an RN or LPN license and 2–4 years of clinical experience. The role involves concurrent reviews, care setting determinations, and collaboration with medical leadership to ensure appropriate care levels across patient populations.

Requirements include nursing licensure (RN/LPN) and a willingness to obtain licensure in additional states as needed. Monday–Friday day schedule with competitive pay and benefits.