Remote NICU Clinical Review Nurse: Utilization & Care

Centene; Illinois; Remote; USD 85.000 - 105.000; Vollzeit

Benefits dieser Stelle

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Zusammenfassung

Centene is seeking a Clinical Review Nurse to perform concurrent reviews, assess acuity and resource use, and support discharge planning for Medicaid and Ambetter/marketplace members. This fully remote position targets experienced NICU nurses.

Ideal candidates have 3+ years NICU level III/IV and 2+ years acute care, with RN or LPN licensure and an accredited nursing education. Remote work, IL-based, with central/eastern time zone preference.

Qualifikationen

• Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing required.
• 3+ years of NICU level III/IV experience required.
• 2+ years of acute care experience required.
• RN licensure in state or compact required; LPN licensure required.

Aufgaben

• Perform concurrent reviews of members for appropriate care and setting.
• Assess acuity level and resource consumption to ensure quality care.
• Collaborate with Medical Affairs/Medical Directors on member care.
• Document our concurrent review findings in health management systems.
• Educate providers on utilization processes for high-quality care.
• Support timely discharge planning and care transitions.

Kenntnisse

NICU nursing

Acute care

Provider communication

Ausbildung

Bachelor's degree in nursing

Graduate from an accredited school of nursing

RN licensure (state or compact)

LPN licensure

Jobbeschreibung

Centene is seeking a Clinical Review Nurse to perform concurrent reviews, assess acuity and resource use, and support discharge planning for Medicaid and Ambetter/marketplace members. This fully remote position targets experienced NICU nurses.

Ideal candidates have 3+ years NICU level III/IV and 2+ years acute care, with RN or LPN licensure and an accredited nursing education. Remote work, IL-based, with central/eastern time zone preference.