Remote RN Supervisor, Utilization Management

Centene Corporation; Enid (OK); Remote; USD 75,000 - 135,000; Full time

Job summary

Centene Corporation is seeking a Nursing Leader to supervise Prior Authorization, Concurrent Review, Retrospective Review Clinical Review, and Appeals teams to ensure appropriate care for members. This remote role requires Oklahoma residency and an active RN license, with on-call weekend coverage expected.

Strong UM knowledge and Microsoft Office proficiency are essential. You will oversee day-to-day UM activities, collaborate with senior management on process improvements, and mentor staff to

Qualifications

• Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.
• Knowledge of utilization management principles preferred.
• RN license required in state or compact state

Responsibilities

• Monitors and oversees utilization management resources to ensure performance, compliance, quality and efficiency.
• Collaborates with UM team to resolve complex care member issues.
• Develops and implements UM policies, procedures, and guidelines.
• Provides coaching and guidance to UM team to ensure adherence to quality and performance standards.
• Onboards, hires, and trains UM team members.
• Leads and champions change within scope of responsibility.

Skills

Leadership

Team management

Utilization management

Microsoft Office

Education

Bachelor's degree in Nursing

Tools

Microsoft Office

Job description

Centene Corporation is seeking a Nursing Leader to supervise Prior Authorization, Concurrent Review, Retrospective Review Clinical Review, and Appeals teams to ensure appropriate care for members. This remote role requires Oklahoma residency and an active RN license, with on-call weekend coverage expected.

Strong UM knowledge and Microsoft Office proficiency are essential. You will oversee day-to-day UM activities, collaborate with senior management on process improvements, and mentor staff to